Quality of Life Issues Following Breast Cancer Treatment.

Breast surgeons are trained in diagnostic modalities, treatment effectiveness, patient safety, and operative techniques, with emphasis on "the right treatment at the right time for the right patient." But delivering quality breast cancer care means more than achieving good outcomes. Physicians have routinely measured disease-free survival and overall survival to determine success in treating breast cancer. Patients are demanding attention to "quality of life" outcomes as well. As clinicians caring for patients with breast cancer, our focus must shift from early detection to survivorship to re-evaluate our own definition of cure and address the important issues affecting the quality of life of all of our patients.

Management of Cystic Conditions.

Cystic conditions are the most common disorder of the breast. Simple cysts are not malignant and do not require intervention. Patients with symptomatic simple cysts can undergo elective aspiration, and typical cyst fluid can be discarded. Bloody fluid should be sent for cytology. Cysts with thick walls, thick septations, or solid components have a risk of malignancy and should undergo biopsy.

Biologic and Synthetic Cellular and/or Tissue-Based Products and Smart Wound Dressings/Coverings.

Cellular and/or tissue-based products (CTPs) have advanced greatly in the past several decades and improve the ability to heal wounds more efficiently. Products can be characterized as nonviable cells, tissue based, animal; nonviable cells, tissue based, human; viable human cells, cultured in vitro, animal substrate; viable human cells, cultured in vitro, synthetic substrate; viable human cells, noncultured, intact tissue. There are approximately 77 different CTPs at the time of this writing, with many more being investigated. Cellular and/or tissue-based product selection, application, postapplication course, and patient selection depend on patient attributes, CTP specifications, and surgeon preference.

Role of Heredity in Melanoma Susceptibility: A Primer for the Practicing Surgeon.

Melanoma is a deadly skin cancer linked to ultraviolet radiation exposure. Heritable traits and sporadic mutations modify an individual's risk for melanoma that may be associated with phenotype. Familial/heritable melanomas are broadly used to describe families with an increased incidence of melanomas, although the underlying mutation may be unknown. Mutations associated with melanoma occur in cell cycle regulation, tumor suppression, chromosomal stability, DNA repair, pigmentation, and melanocyte differentiation genes. Genetic testing of individuals with a family history of melanoma may provide additional etiologic information and ensure patients with known markers for cancer development are closely monitored by physicians.