Body image disturbance and surgical decision making in egyptian post menopausal breast cancer patients.

BACKGROUND: In most developing countries, as in Egypt; postmenopausal breast cancer cases are offered a radical form of surgery relying on their unawareness of the subsequent body image disturbance. This study aimed at evaluating the effect of breast cancer surgical choice; Breast Conservative Therapy (BCT) versus Modified Radical Mastectomy (MRM); on body image perception among Egyptian postmenopausal cases. METHODS: One hundred postmenopausal women with breast cancer were divided into 2 groups, one group underwent BCT and the other underwent MRM. Pre- and post-operative assessments of body image distress were done using four scales; Breast Impact of Treatment Scale (BITS), Impact of Event Scale (IES), Situational Discomfort Scale (SDS), and Body Satisfaction Scale (BSS). RESULTS: Preoperative assessment showed no statistical significant difference regarding cognitive, affective, behavioral and evaluative components of body image between both studied groups. While in postoperative assessment, women in MRM group showed higher levels of body image distress among cognitive, affective and behavioral aspects. CONCLUSION: Body image is an important factor for postmenopausal women with breast cancer in developing countries where that concept is widely ignored. We should not deprive those cases from their right of less mutilating option of treatment as BCT.

Dye assisted lymphatic sparing subinguinal varicocelectomy. A prospective randomized study.

BACKGROUND: Division of lymphatic vessels during varicocelectomy could lead to hydrocele formation and decrease in testicular function due to testicular edema. We determined if the use of methylene blue combined with optical magnification reduces the incidence of post-varicocelectomy hydrocele. METHODS: Consecutive patients treated for varicocele at our institution were evaluated for inclusion. Participants were randomly allocated to receive either subinguinal varicocelectomy after 2 ml intratunical space injection of methylene blue and group 2 in whom no mapping technique was adopted during subinguinal varicocelectomy. After surgery, the patients were assessed at 2 weeks, 6 and 12 months for hydrocele, testicular edema, varicocele recurrence, atrophy, pain or other complications with mean follow-up was 15 ± 7 months. RESULTS: Eighty patients with varicocele were randomized and completed the study. There were no intra complications in either group. In group (1) no patient had a hydrocele after surgery. By contrast, in group (2) there were four cases of secondary hydrocele (10%; P = 0.041)); no testicular hypertrophy was observed following lymphatic sparing surgery; One patient in each group had varicocele recurrence. Pregnancy was reported in 30 patients (37.5%) during the follow-up period, 17 of them (42.5%) were group (1) difference was not significantly different among both groups. CONCLUSIONS: Subinguinal varicocelectomy using combination of optical magnification and lymphatic staining (methylene blue) offers simple and quick preservation of the draining lymphatic vessels and avoids secondary hydrocele formation. ClinicalTrials.gov ID: NCT01259258.