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Archive for Doctor Advice for Breast Care


Natural breast augmentation is a new procedure that transplants fat taken from your own body via liposuction to add volume to the breasts. This fat transfer technique is relatively new and there aren't very many physicians performing this procedure currently. Those who do use it though are confident in its safety and effectiveness.

This procedure is a safe and effective way to enhance the size of the breasts, while simultaneously removing fat where it’s not wanted, all without invasive surgery. The best candidate for Natural Breast Enhancement is that person who has lost fullness in her breasts due to age, weight fluctuations or breast feeding, and desires an increase in size and fullness of up to 1 to 2 cup sizes.

The Natural Breast Enhancement procedure with Body-Jet Liposuction, which is also known as Water Assisted Liposuction. It is performed in-office under local anesthesia. Using a fan-shaped nozzle, pulsating water loosens fat cells from connective tissue while vital structures such as blood vessels remain mostly intact. This is performed on a donor area that is rich in fat, such as the hips, thighs, stomach, or buttocks – conveniently, places where fat removal is most desired.

Fat tissue is the most abundant source of adult stem cells, which can develop into other cell types.After harvesting the fat, adult stem cells, which differ from embryonic stem cells, will actually develop into blood vessel cells to aid the body in accepting the transplanted fat. After fat is removed from the donor site, it is carefully placed in the breast using a specialized injection cannula. The use of Body-Jet Liposuction is integral in this procedure because the fat cells from the donor site are extracted intact and can be injected back into the breast. There could be a decrease in what was initially injected due to some fat cells that do not successfully “take” but the injections will typically result in a permanent 150 cc to 250 cc, roughly 1-2 bra cup sizes, overall increase.

This breast augmentation procedure, which includes harvesting the fat from the Body-Jet Liposuction, takes approximately 4-5 hours. In comparison to traditional breast augmentation, there is less swelling and postoperative pain and bruising. Post operation,a support bra be utilized to ensure fat remains in place.

“It is important for the public to know that although there are many myths about this procedure, the American Society of Plastic Surgeons issued a policy paper supporting the safety of Natural Breast Enhancement in March, 2009,” says Dr. Robert Langdon. “New techniques have made this procedure a safe and effective alternative for breast enhancement. One popular myth is that most of the fat cells die, making the procedure ineffective; however, new techniques result in 85-90% fat cell survival.”

Not for candidates who are looking for a dramatic change in breast size, Natural Breast Enhancement is an excellent option for any woman who is looking to add up to 1-2 cup sizes without artificial implants.

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Natural breast augmentation is a new procedure that transplants fat taken from your own body via liposuction to add volume to the breasts. This fat transfer technique is relatively new and there aren't very many physicians performing this procedure currently. Those who do use it though are confident in its safety and effectiveness.

This procedure is a safe and effective way to enhance the size of the breasts, while simultaneously removing fat where it’s not wanted, all without invasive surgery. The best candidate for Natural Breast Enhancement is that person who has lost fullness in her breasts due to age, weight fluctuations or breast feeding, and desires an increase in size and fullness of up to 1 to 2 cup sizes.

The Natural Breast Enhancement procedure with Body-Jet Liposuction, which is also known as Water Assisted Liposuction. It is performed in-office under local anesthesia. Using a fan-shaped nozzle, pulsating water loosens fat cells from connective tissue while vital structures such as blood vessels remain mostly intact. This is performed on a donor area that is rich in fat, such as the hips, thighs, stomach, or buttocks – conveniently, places where fat removal is most desired.

Fat tissue is the most abundant source of adult stem cells, which can develop into other cell types.After harvesting the fat, adult stem cells, which differ from embryonic stem cells, will actually develop into blood vessel cells to aid the body in accepting the transplanted fat. After fat is removed from the donor site, it is carefully placed in the breast using a specialized injection cannula. The use of Body-Jet Liposuction is integral in this procedure because the fat cells from the donor site are extracted intact and can be injected back into the breast. There could be a decrease in what was initially injected due to some fat cells that do not successfully “take” but the injections will typically result in a permanent 150 cc to 250 cc, roughly 1-2 bra cup sizes, overall increase.

This breast augmentation procedure, which includes harvesting the fat from the Body-Jet Liposuction, takes approximately 4-5 hours. In comparison to traditional breast augmentation, there is less swelling and postoperative pain and bruising. Post operation,a support bra be utilized to ensure fat remains in place.

“It is important for the public to know that although there are many myths about this procedure, the American Society of Plastic Surgeons issued a policy paper supporting the safety of Natural Breast Enhancement in March, 2009,” says Dr. Robert Langdon. “New techniques have made this procedure a safe and effective alternative for breast enhancement. One popular myth is that most of the fat cells die, making the procedure ineffective; however, new techniques result in 85-90% fat cell survival.”

Not for candidates who are looking for a dramatic change in breast size, Natural Breast Enhancement is an excellent option for any woman who is looking to add up to 1-2 cup sizes without artificial implants.

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Overview
Your doctor or health care provider might ask you to do the following diagnosis tests, when he saw changes in your mammogram or suspicious finding of breast cancer on his clinical examination. The following testes are for diagnosis of breast cancer.
Diagnostic Mammogram
An x-ray of the breast.

Biopsy
The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a lump in the breast is found, the doctor may need to remove a small piece of the lump. Four types of biopsies are as follows:

Excisional biopsy: The removal of an entire lump of tumor.
Incisional biopsy: The removal of part of a lump or a sample of tissue.
Core biopsy: The removal of tissue using a wide bore needle.
Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid, using a thin needle.
Estrogen and progesterone receptor test
A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out whether estrogen and progesterone could affect the way cancer grows. The test results show whether hormone therapy may stop the cancer from growing.

MRI (magnetic resonance imaging)
A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

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The three ways that cancer spreads in the body are:

Through tissue: Cancer cells reach the surrounding normal tissue.

Through the lymph system: Cancer cells are carried by the lymphatic vessels and reaching the other part of the body.

Through the blood: Veins and capillaries carry cancer cells to other part of the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the lungs, the cancer cells in the lungs are actually breast cancer cells. The disease is metastatic breast cancer, not lungs cancer.

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After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body. The process is called staging. It is important to know the stage in order to plan treatment.
Stage 0 (carcinoma in situ)
There are 2 types of breast carcinoma in situ:
Ductal carcinoma in situ (DCIS) is a noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive.
Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast. This condition seldom becomes invasive cancer; however, having lobular carcinoma in situ in one breast increases the risk of developing breast cancer in either breast.
Stage I
Cancer has formed. The tumor is 2 centimeters or smaller and has not spread outside the breast.
Stage IIA
No tumor is found in the breast, but cancer is found in the axillary lymph nodes (the lymph nodes under the arm); or
The tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or
The tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.
Stage IIB
The tumor is larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or
The tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes.
Stage IIIA
No tumor is found in the breast. Cancer is found in axillary lymph nodes that are attached to each other or to other structures, or cancer may be found in lymph nodes near the breastbone; or
The tumor is 2 centimeters or smaller. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone; or
The tumor is larger than 2 centimeters but not larger than 5 centimeters. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone; or
The tumor is larger than 5 centimeters. Cancer has spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.
Stage IIIB
The tumor may be any size and cancer:
The tumor has spread to the chest wall and/or the skin of the breast; and
It may have spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.
Cancer that has spread to the skin of the breast is inflammatory breast cancer.
Stage IIIC
There may be no sign of cancer in the breast or the tumor may be any size and may have spread to the chest wall and/or the skin of the breast. Also, cancer has spread to lymph nodes above or below the collarbone; and may have spread to axillary lymph nodes or to lymph nodes near the breastbone.
Stage IIIC breast cancer is divided into operable and inoperable stage IIIC.

Operable stage IIIC,
The cancer is found in ten or more axillary lymph nodes; or
It is found in lymph nodes below the collarbone; or
It is found in axillary lymph nodes and in lymph nodes near the breastbone.
Inoperable stage IIIC
The cancer has spread to the lymph nodes above the collarbone.
Stage IV
The cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.

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Many women with breast cancer want to take an active part in making decisions about their medical care. It is natural to want to learn all about your disease and treatment choices. Knowing more about breast cancer helps many women cope.Women with breast cancer have many treatment options. These include surgery, radiation therapy, chemotherapy, hormone therapy, and biological therapy. Depend upon the stage of the breast cancer and associate conditions; it will be single or combine therapy.

Surgery

The first line of therapy against breast cancer is the surgery. It may be

Lumpectomy is the removal of only the lump and a small portion of surrounding tissue.

Mastectomy is the removal of all of the breast tissue with or without the muscles under the breast.

Lumpectomy with lymph node removal is the removal of the tumor and small part of surrounding tissue, together with the axillary lymph node, when the biopsy shows that the breast cancer has spread outside the milk duct.

Mastectomy with lymph node removal is the removal of all breast tissue with the associated lymph nodes when biopsy result shows spreading of cancer outside the breast tissue.

Prophylactic mastectomy is preventive removal of the breast to lower the risk of breast cancer in high-risk people.

Prophylactic ovary removal is a preventive surgery that lowers the amount of estrogen which is produced from the ovaries and that stimulates the growth of cancer cells.

Breast reconstruction is the rebuilding of the breast shape after mastectomy and sometimes lumpectomy. Reconstruction can take place at the same time as cancer-removing surgery, or months to years later. The reconstructed breast may be made with the patient’s own (nonbreast) tissue or by using implants filled with saline or silicone gel.

Even if the surgeon removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy, chemotherapy, or hormone therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy, that include radiation therapy, chemotherapy and hormonal therapy.

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Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.Radiations often used to destroy any remaining breast cancer cells in the breast, chest wall, or axilla (underarm) area after surgery. Occasionally, radiation therapy is used before surgery to shrink the size of a tumor. Radiation therapy may occasionally be recommended for women to destroy remaining cancer cells after mastectomy (surgical removal of the affected breast) or to shrink tumors in patients with advanced breast cancer.
There are two types of radiation therapy.

External radiation therapy uses a machine outside the body to send radiation toward the cancer.The procedure itself is pain-free. As part of treatment after breast surgery, patients are typically treated with radiation five times per week for at least six weeks in an outpatient clinical setting. Each treatment generally lasts a few minutes; the entire radiation session after machine set-up typically lasts 15 to 30 minutes.Side effects of external beam therapy vary among patients.Temporary side effects of radiation therapy are
* Fatigue
* Neutropenia (reduction in white blood cells)
* Breast swelling or tenderness
* Feeling of heaviness in the breast
* Sunburn-like appearance of the breast skin
* Loss of appetite

Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.Common side effects of internal radiation therapy include risk of infection and breast swelling.

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Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Hormone therapy
Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working. The hormone estrogen, which makes some breast cancers grow, is made mainly by the ovaries. Treatment to stop the ovaries from making estrogen is called ovarian ablation.

Clinical trials for newer treatment
Below are the some new types of treatment that are being tested in clinical trials. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Sentinel lymph node biopsy followed by surgery
High-dose chemotherapy with stem cell transplant
Monoclonal antibodies as adjuvant therapy
Tyrosine kinase inhibitors as adjuvant therapy

Many of today’s standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Clinical trials are taking place in many parts of the country. For the new treatment or want to take part in clinical trials, consult with your health care provider.

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There are many ways to increase milk supply, even if the circumstances seem overwhelming or near impossible. The important thing is to nurse as frequently as possible and maintain a dedication and determination to breast feed.

1. Reduce your stress level. Probably the most overlooked factor of any change in the body is the lack of quality relaxation and a stress-free environment. Delegate tasks, put projects to the side until the breast milk supply is back under control. When nursing your baby, do so in a quiet room with no distractions. This is your opportunity to put your feet up for a few minutes and relax. The simple act of relaxing will encourage letdown; and at the same time there is nothing to distract the baby and make him stop nursing before he's actually full.

2. Drink plenty of water. A body that doesn't receive enough fluid intake is going to have a problem producing fluid! Drink at least a gallon of water a day. A good habit is to do this while baby is nursing; so that you do not forget.

3. Massage your breasts often. Babies will naturally knead the breast, triggering letdown. Take the time to massage your breasts while in the shower or bath, periodically throughout the day – such as when you're in the bathroom, and especially while baby is nursing. Even though the letdown may not produce a leaking breast or a spray of milk, it will still occur. This will signal to the breast that the baby is nursing more often, even if in reality he isn't. The breast will increase supply accordingly.

4. Watch your diet. A diet that consists of quick-fix food and loads of caffeine isn't good for mother or baby. As well as needing plenty of fluids, your body also needs lots of nutrients to provide a nutritious meal for your baby. For a quick snack, grab some fruit instead of a candy bar or fast food. For a nutritious, yet time-saving meal, throw something into a crock pot in the morning. At dinnertime the meal will be cooked and ready, without you having to spend time watching over it. Vitamin-rich vegetables, protein-filled meats, and hundreds of different casseroles can be prepared in a crock pot with little or no effort, saving you plenty of time.

6. Use natural herbs. Even major chain department stores now carry various types of herbs in capsule form; freshly ground herbs can be purchased at health food stores and online. Fenugreek is an excellent herb to help increase milk supply. It is an expectorant and has no side effects other than causing your milk to have a maple syrup scent. Milk Thistle is another wonderful supply enhancer, although not quite as effective as Fenugreek. There are also many brand-name teas available, such as Mother's Milk, or Mother's Milk Two for pregnant mothers who are nursing.

Take heart! There are ways to increase your milk supply or even bring back a supply that has completely dried up. Remember that your body grew your baby, and there is no better food than what your body custom-produces for your child. Formula does not provide the antibodies to illness that breast milk does, nor does it change and adjust according to the age and needs of your child like your breast milk does.

With a little effort and determination, you can overcome any breast feeding obstacle and give your child the food that Mother Nature intended!

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Gross Anatomy

Each breast has 15 to 20 sections, called lobes, each with many smaller lobules. The lobules end in dozens of tiny bulbs that can produce milk. Lobes, lobules and bulbs are all linked by thin tubes called ducts. These ducts lead to the nipple, which is centered in a dark area of breast skin called the areola. The areola also has oil-producing glands that secrete a lubricant to make breastfeeding easier. The spaces between the lobules and ducts are filled with fat. There are no muscles in the breast, but muscles lie under each breast and cover the ribs.

Breast Parenchyma and Support Structures

The breast is made up of both fatty tissue and glandular milk-producing tissues. The ratio of fatty versus glandular tissue varies among individuals. In addition, with the onset of menopause (ie, decrease in estrogen levels), the relative amount of fatty tissue increases as the glandular tissue diminishes. The soft tissues of the breast are supported by the suspensory ligaments of Cooper. These ligaments run throughout the breast tissue parenchyma from the deep fascia beneath the breast and attach to the dermis of the skin and they allow for the natural motion of the breast.

Blood Supply

Blood supply of the breast skin depends on the subdermal plexus, which is in communication with underlying deeper vessels supplying the breast parenchyma.

The blood supply is derived from

  • Perforating branches of the internal mammary artery
  • Lateral thoracic artery
  • Thoracodorsal artery
  • Intercostal artery perforators
  • Thoracoacromial artery

This rich blood supply allows for a variety of reduction techniques, ensuring the viability of the skin flaps after surgery.

Nerve Supply

Sensory innervation of the breast is dermatomal in nature. It is mainly derived from the anterolateral and anteromedial branches of thoracic intercostal nerves T3-T5. Supraclavicular nerves from the lower fibers of the cervical plexus also provide innervation to the upper and lateral portions of the breast. Researchers believe sensation to the nipple derives from the lateral cutaneous branch of T4.

Muscle Related To The Breast

The breast lies over the muscles that encase the chest wall. These are pectoralis major, serratus anterior, external oblique, and rectus abdominus fascia. The blood supply that provides circulation to these muscles then perforates through to the breast parenchyma, thus also supplying blood to the breast. By maintaining continuity with the underlying musculature, the breast tissue remains richly perfused, thus preventing complications arising from aesthetic or reconstructive surgery requiring the placement of a breast implant.

Pectoralis major

The pectoralis major muscle extends from its origin on the medial clavicle and lateral sternum to its insertion on the humerus. The action of the pectoralis major is to flex, adduct, and rotate the arm medially. The pectoralis major is extremely important in both aesthetic and reconstructive breast surgery, since it provides muscle coverage from the breast implant.

Serratus anterior

The serratus anterior muscle is a broad muscle that runs along the anterolateral chest wall. Its origin is the outer surface of the upper borders of the first through eighth ribs and its insertion is on the deep surface of the scapula. To completely cover the implant with muscle in reconstructive surgery, often the serratus anterior must be elevated sharply to obtain a sufficient muscle layer to provide coverage.

Rectus abdominus

The rectus abdominus muscle provides the inferior border to the breast. It is an elongated muscle that runs from its origin at the crest of the pubis and interpubic ligament to its insertion at the xiphoid process and cartilages of the fifth through seventh ribs. It acts to compress the abdomen and flex the spine. When placing an implant for breast reconstruction, in attempting to achieve complete coverage with muscle, the rectus fascia must often be elevated to place the implant sufficiently inferior. This dense thick fascia is often intimately adherent to the ribs below it.

External oblique

The external oblique muscle is a broad muscle that runs along the anterolateral abdomen and chest wall. It abuts the breast on the inferior lateral aspect. It elevated along with the rectus abdominus fascia to provide inferior coverage of the breast implant during reconstructive surgery.

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