Utjecaj estetskih rezultata poštedne operacije karcinoma dojke na kvalitetu života i pojavu simptoma depresivnih poremećaja

Breast cancer is the leading malignancy in females in the western world as well as in Croatia. In the last 20 years, the standard method of treatment disease was a complete mastectomy with lymphadenectomy of axillary lymph nodes. Modern treatment includes a conservative resection of the breast and is the standard choice at the Clinical Hospital Center Rebro where over 60% of all breast cancer operations are done with conservative methods including techniques such as quadrantectomy, and sentinel lymph node biopsy. Frequently during surgery oncoplastic techniques are used. Other than surgical treatment, mandatory adjuvant therapies such as radiotherapy, and depending on the histological features of the tumor and the extent of invasion and distant metastasis, chemotherapy and/or hormonal therapy is used. When approaching the patient, other than oncologic treatment which is the main concern for the surgeon, the disease is must be viewed from a wider perspective which includes the patient's quality of life. Quality of life depends directly on the method and outcome of treatment. Our observations and research has shown that better aesthetic results increases the patients quality of life. Quality of life is worse in patients who on the personality tests rank higher in the section for neuroticism. Neuroticism is closely associated with a higher score on the Beck depression test. Extroversion is not associated with the occurrence of depression, nor with the result of the quality of life questionnaire. From anthropometric measurements before and after surgery, we found a statistically significant association with the difference of the distance between the nipple and inframammary fold. The larger the distance, the lower quality of life. Research results suggest that based on the conducted testing and measurements, we can predict patients with an increased risk for developing symptoms of depression and reduced quality of life. Early psychological treatment and support within the hospital or psychological consultation which are offered by organisations for patients suffering from breast cancer could reduce morbidity and improve quality of life. It is also to be expected that patients who are recognized as high risk and treated earlier due to dissatisfaction of the aesthetic result would use less sick days and thus reduce the total financial cost of treatment

Immunohistochemical Expression of Matrix Metalloproteinase-1 and Cyclooxygenase-2 in Cutaneous Squamous Cell and Basal Cell Carcinoma

The most common nonmelanoma skin cancers (NMSC) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The incidence of NMSC is 18-20 times higher than the incidence of melanoma. The Cyclooxygenase- 2 (COX-2) and Matrix Metalloproteinase-1 (MMP-1) enzymes have both been linked to the development of these diseases but their exact significance is unknown. We conducted a retrospective analysis on 148 adult patients with cutaneous BCC and SCC. Cases were divided according to the sub-types of BCC and the degree of SCC differentiation. Immunohistochemical staining for COX-2 and MMP-1 was performed and analyzed to determine if the expression of these biomarkers were associated with BCC subtypes and the degree of SCC. differentiation. We did not find a significant association of the level of differentiation of SCC with the immunohistochemical expression for MMP-1 or COX-2. There was a significant association between BCC subtypes and immunohistochemical expression for MMP-1; positive expression of this enzyme reduces the odds for the infiltrative subtypes by 90%. A marginally significant association between BCC subtypes and immunohistochemical expression for COX-2 was also found. This enzyme was highly expressed in non-infiltrative basal cell carcinoma types (94%) compared with infiltrative types (71%). In conclusion, we did not find a significant predictor for SCC expression levels for either of two biomarkers, while the expression of MMP-1 in BCC was significantly inversely associated with the infiltrative type (moderate sensitivity and high specificity). Further research with larger sample sizes is needed to precisely determine the role these enzymes have in these diseases

Immunohistochemical Expression of Matrix Metalloproteinase-1 and Cyclooxygenase-2 in Cutaneous Squamous Cell and Basal Cell Carcinoma

The most common nonmelanoma skin cancers (NMSC) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The incidence of NMSC is 18-20 times higher than the incidence of melanoma. The Cyclooxygenase- 2 (COX-2) and Matrix Metalloproteinase-1 (MMP-1) enzymes have both been linked to the development of these diseases but their exact significance is unknown. We conducted a retrospective analysis on 148 adult patients with cutaneous BCC and SCC. Cases were divided according to the sub-types of BCC and the degree of SCC differentiation. Immunohistochemical staining for COX-2 and MMP-1 was performed and analyzed to determine if the expression of these biomarkers were associated with BCC subtypes and the degree of SCC. differentiation. We did not find a significant association of the level of differentiation of SCC with the immunohistochemical expression for MMP-1 or COX-2. There was a significant association between BCC subtypes and immunohistochemical expression for MMP-1; positive expression of this enzyme reduces the odds for the infiltrative subtypes by 90%. A marginally significant association between BCC subtypes and immunohistochemical expression for COX-2 was also found. This enzyme was highly expressed in non-infiltrative basal cell carcinoma types (94%) compared with infiltrative types (71%). In conclusion, we did not find a significant predictor for SCC expression levels for either of two biomarkers, while the expression of MMP-1 in BCC was significantly inversely associated with the infiltrative type (moderate sensitivity and high specificity). Further research with larger sample sizes is needed to precisely determine the role these enzymes have in these diseases

QUALITY OF LIFE AND DEPRESSION AMONG FEMALE PATIENTS UNDERGOING SURGICAL TREATMENT FOR BREAST CANCER: A PROSPECTIVE STUDY

Background: Breast carcinoma is the most common malignant disease in women in the majority of developed countries. The development of depression as well as the quality of life (QoL) in these patients depends not only on the result of oncologic treatment, but on the cosmetic outcome as well. The primary aim of this prospective study was to investigate the changes in QoL and depressive symptoms among patients undergoing surgical treatment for breast cancer. Subjects and methods: We conducted a prospective study that included 100 female patients (mean age 60.26 years) who underwent surgical and oncological treatment for breast carcinoma at the University Hospital Center Zagreb, Croatia. The patients were photographed before and after treatment and were required to fill out a standardized quality of life questionairres QLQ – C30 and QLQ – BR23, Beck Depression Inventory (BDI) and a questionnaire on breast asymmetry. Results: Our results show that patients had significantly higher QoL levels compared with their pre-surgical results. Statistical trend of a lower degree of depression was also observed. A worse cosmetic outcome (i.e., postoperative assymetry) was associated with a lower QoL, but there was no association with depression. Depression was significantly related to the level of pain and lower financial status. Conclusion: QoL improved after surgical treatment of breast cancer and was dependant on postoperative asymmetry, whereas the findings for depressive symptoms remained less clear. Future research should investigate more factors that may contribute to the QoL and degree of depression in this patient population

Endoscopically Assisted Latissimus Dorsi Flap Harvesting and Breast Reconstruction in Young Female with Poland Syndrome

We will describe a second phase of breast reconstruction on a young girl suffering from Poland syndrome. She has the breast, pectoralis major and minor muscle aplasia on the right side. She has no other deformities. The best result is achieved by combining latissimus dorsi flap and a silicone implant, and even better aesthetic result is accomplished with endoscopically assisted latissimus dorsi harvesting. Purpose of this operation is to correct the chest asymmetry and to accomplish good aesthetic result

Pseudocista nakon abdominoplastike: prikaz slučaja

Abdominoplasty is one of the most popular aesthetic body contouring procedures. Seroma formation is the most common early complication after abdominoplasty. Usually, it resolves with punctions and seroma evacuation. Chronic seroma and pseudocyst formation is a rare complication and it demands surgical intervention. Based on our experience from the described case, the pseudocyst needs to be radically extirpated and a combination of quilting sutures, fibrin glue, three weeks of suction drainage, and compressive garments should be used to prevent recurrence.Abdominoplastika je jedan od najpopularnijih zahvata za oblikovanje tijela, a stvaranje seroma je najčešća rana komplikacija tog zahvata. Obično se uspješno rješava punkcijama i evakuacijom seroma. Kronični serom može dovesti do stvaranja pseudociste ili pseudoburze, rijetke komplikacije koja zahtijeva kirurško liječenje. Prema našem iskustvu i novijoj literaturi radikalna ekstirpacija pesudociste je nužna kako bi se spriječilo ponovno stvaranje seroma, uz dodatnu uporabu sidrenih šavi, fibrinskog ljepila, sukcijske drenaže te nošenja elastičnog steznika

Endoscopically Assisted Latissimus Dorsi Flap Harvesting and Breast Reconstruction in Young Female with Poland Syndrome

We will describe a second phase of breast reconstruction on a young girl suffering from Poland syndrome. She has the breast, pectoralis major and minor muscle aplasia on the right side. She has no other deformities. The best result is achieved by combining latissimus dorsi flap and a silicone implant, and even better aesthetic result is accomplished with endoscopically assisted latissimus dorsi harvesting. Purpose of this operation is to correct the chest asymmetry and to accomplish good aesthetic result

THE ACCEPTANCE OF COSMETIC SURGERY SCALE (ACSS) AND ITS CORRELATIONS WITH PSYCHOLOGICAL CHARACTERISTICS AMONG THE CROATIAN POPULATION

Background: This study aimed to examine the results of Acceptance of Cosmetic Surgery Scale among the Croatian population and its correlations with other scales and demographic data. Subject and methods: The sample consisted of 420 people who voluntarily filled out an online questionnaire. They completed demographic questions and four scales: Acceptance of Cosmetic Surgery Scale (ACSS), Rosenberg Self-Esteem Scale (RSES), Satisfaction With Life Scale (SWLS), and Body Appreciation Scale-2 (BAS-2). Results: ACSS scale showed five statistically significant differences between genders and a higher overall score in women, but no significant differences were recorded in three ACSS subscales and the overall ACSS score. In contrast to men, women respondents recorded a significant negative correlation between ACSS subscales score (Social, Consider) and BAS-2 and Satisfaction with life score, while a positive correlation was recorded with BMI. Conclusion: The ACSS score among the Croatian population was higher than the results among the Italian and Serbian population, and similar to the original American study, which tells us that the Croatian population accepts and considers cosmetic surgery a lot. Furthermore, our results are important for practitioners and patients because they revealed correlations between ACSS scores and the self-thinking scale