Introduction

The position in which a baby is born can have a significant impact on their health and wellbeing. In most cases, a baby is born head-first, known as a vertex position. However, there are cases where a baby is born bottom-first, known as a breech position. Historically, breech births have been considered more dangerous and often resulted in a cesarean section delivery. However, a new study published in the American Journal of Obstetrics and Gynecology has found that head-first births before 32 weeks of gestation are safe, even if the baby is in a breech position. In this article, we will explore the study’s findings and what they could mean for the management of breech births.

The Study

The study looked at the outcomes of nearly 1,500 premature babies who were born between 28 and 32 weeks of gestation in breech or vertex positions. The researchers found that there was no significant difference in the rates of complications or mortality between babies born head-first or bottom-first. Additionally, the study found that babies born head-first in the breech position were not at a higher risk of complications or mortality compared to those born in the vertex position.

Implications for Breech Birth Management

The findings of this study have important implications for the management of breech births, particularly for premature babies. Historically, breech births have been considered more dangerous and often resulted in a cesarean section delivery. However, this study suggests that head-first births before 32 weeks of gestation can be safely managed through spontaneous vaginal delivery, even if the baby is in a breech position.

Importantly, the study highlights the need for personalized care and careful consideration of each individual case. While head-first births may be safe in certain circumstances, there are factors such as the baby’s size, the mother’s health, and the presence of other complications that may warrant a cesarean delivery. Women should work closely with their healthcare providers to ensure that the safest delivery method is chosen for their individual circumstances.

Conclusion

The study published in the American Journal of Obstetrics and Gynecology suggests that head-first births before 32 weeks of gestation are safe, even if the baby is in a breech position. This has important implications for the management of breech births, particularly for premature babies. While head-first births may be safe in certain circumstances, personalized care and careful consideration of each individual case are important. Women should work closely with their healthcare providers to ensure that the safest delivery method is chosen for their individual circumstances. As research in this area continues to develop, it is important that best practices for breech births are based on the best available evidence and tailored to each individual’s unique needs.

On September 21, 2012, the National Institutes of Health reported that infants delivered head-first in standard deliveries before the 32^nd term are just as likely to survive as infants delivered by a planned cesarean.

Infants born before the 32^nd week face an increased risk of “death, cerebral palsy, developmental delays, infections and vision and hearing problems.”  Many studies have argued that infants delivered vaginally before the 32^nd week face an increased risk of injury or other health risks once passing through the birth canal, and many of the same studies have promoted cesarean deliveries in such situations.

However, the NIH argues otherwise.  In the recent study, the NIH compared results between about 3,000 women who underwent a head-first, standard delivery and those who chose a planned cesarean delivery.

The NIH reports, “Nearly 80 percent of the women with a fetus positioned head-first attempted a vaginal delivery, and 84 percent of them were successful.  The remainder ultimately delivered by cesarean.”  The success rate was the same for planned cesareans.

The survival rate for breached infants under 32 weeks is significantly higher during a planned cesarean.  Uma M. Reddy, M.D., M.P.H., of the Eunice Kennedy Shriver National Institute of Child Health and Human Development states, “The decision to deliver vaginally or by cesarean is an individual one, and must be made carefully by the woman, in close consultation with her physician”

The NICHD conducted the study, and their next goal is to understand the results from “extremely preterm” deliveries and the neurological and physical disabilities associated with such deliveries.

The study presents several challenges in medical malpractice law.  A doctor is now less liable if they suggest a head-first, standard delivery before the 32^nd week.  Still, the link between preterm deliveries and neurological disabilities needs studied further.

Source: National Institutes of Health

Introduction

Heart valve replacement surgery has been a lifesaving procedure for thousands of patients over the years. Traditional heart valve replacement surgery involves an open-heart procedure, which can be risky and require a long recovery time. However, the development of the Sapien artificial heart valve has revolutionized heart valve replacement surgery. The Sapien valve is inserted into the heart through a small incision, making the procedure much less invasive and reducing recovery time. In October 2012, the use of the Sapien valve was expanded to include patients who are not candidates for traditional heart valve surgery. In this article, we will explore the features of the Sapien valve and the implications of its expanded use.

The Sapien Valve

The Sapien valve is a bioprosthetic valve that is made from animal tissue and mounted on a stent frame. The valve is designed to be inserted into the heart through a small incision in the leg or chest, using a catheter. Once in place, the valve expands to fit the patient’s natural valve, effectively replacing the damaged or diseased valve.

The Sapien valve has been used successfully in patients with aortic stenosis, a condition where the heart’s aortic valve becomes narrow and obstructs blood flow. The valve has been shown to reduce symptoms and improve survival rates in patients with this condition compared to medical management alone.

Expanded Use

In October 2012, the U.S. Food and Drug Administration (FDA) approved the expanded use of the Sapien valve for patients who are not candidates for traditional heart valve surgery. This includes patients who are considered high-risk for open-heart surgery due to factors such as their age, frailty, or other medical conditions.

The expanded use of the Sapien valve opens up new treatment options for these patients, who may have previously been deemed too high-risk for surgery. With the use of the Sapien valve, these patients can undergo heart valve replacement without the high risks associated with open-heart surgery.

Implications for Patients and Healthcare Providers

The expanded use of the Sapien valve has important implications for patients and healthcare providers. Patients who are not candidates for traditional heart valve surgery can now receive life-saving treatment with a less invasive procedure. This can improve their quality of life and potentially extend their lifespan.

For healthcare providers, the expanded use of the Sapien valve offers a new treatment option for high-risk patients. The minimally invasive procedure and reduced recovery time also mean that patients can be treated more efficiently, which can lead to cost savings for the healthcare system as a whole.

Conclusion

The expanded use of the Sapien artificial heart valve offers new treatment options for patients who are not candidates for traditional heart valve surgery. The minimally invasive procedure and reduced recovery time can improve patient outcomes and potentially extend their lifespan. For healthcare providers, the expanded use of the Sapien valve offers a new treatment option for high-risk patients and can lead to cost savings. As the use of the Sapien valve continues to expand, it is important to carefully evaluate patient suitability and ensure that best practices are followed for the safe and effective use of this innovative technology.

On October 19, 2012, the Food and Drug Administration approved the expanded use of the Sapien Transcatheter Heart Valve (THV).  Patients with aortic valve stenosis who can receive surgery but appear at risk of serious complications during surgery are now approved for the heart valve.

The Sapien THV was first approved in 2011 for patients who could not undergo surgery for aortic valve stenosis.  The condition occurs when calcium deposits occur on the aortic valve and cause it to narrow.  The heart will eventually work harder to push blood through the reduced opening, and aortic valve stenosis can eventually lead to fainting, chest pain, heart failure, arrhythmias, or even cardiac arrest.

The Sapien THV does not require a surgeon to open the chest or heart.  Instead, the THV is compressed into a small tube referred to as a delivery catheter.  The delivery catheter and the THV are then placed in the femoral artery in the leg and threaded to the bad valve.  Lastly, the THV is released from the delivery catheter and then increased to normal size with a balloon.  The inserted THV begins working right away.

The use of the Sapien THV was expanded after a clinical study compared results between 348 patients who received the THV through the delivery catheter and 351 patients who received a valve replacement during open-heart surgery.  The groups experienced similar death rates during the first month, first year, and first two years.  THV recipients are at an increased risk of artery dissection or perforation, and the same patients are at risk of stroke during the first month after the procedure.

Christy Foreman, the director at the FDA’s Center for Devices and Radiological Health, stated, “Any procedure to replace the aortic valve carries the risk for serious complications, but for some patients with coexisting conditions or diseases that risk may be especially high.  The THV serves as an alternative for some very high-risk patients.”

Source: U.S. Food and Drug Administration

Introduction

Plan B is a form of emergency contraception that can prevent pregnancy if taken within 72 hours of unprotected sex. While the drug is available over the counter without a prescription, there is growing concern among doctors that women who could benefit from Plan B may not have access to it. In September 2012, a group of doctors called for Pre-Emptive Plan B Prescriptions to be made available to all women of reproductive age. In this article, we will explore why doctors are calling for Pre-Emptive Plan B Prescriptions and what this could mean for women’s health.

Access to Plan B

Although Plan B is available over the counter without a prescription, studies have shown that many women face barriers to accessing the drug. These barriers can be financial, logistical, or related to stigma and misinformation. As a result, women who could benefit from Plan B may not have access to it when they need it.

Pre-Emptive Plan B Prescriptions

Pre-Emptive Plan B Prescriptions involve healthcare providers writing a prescription for Plan B that a woman can fill before she needs it. This would ensure that women have access to the drug when they need it and remove the barriers associated with obtaining the drug in a state of emergency.

The call for Pre-Emptive Plan B Prescriptions has been led by a group of doctors who are concerned about the low uptake of emergency contraception and the resulting unintended pregnancies. By providing women with a prescription for Plan B before they need it, doctors hope to increase access to the drug and reduce the number of unintended pregnancies.

Implications for Women’s Health

The availability of Pre-Emptive Plan B Prescriptions has important implications for women’s health. By removing the barriers to access and increasing the availability of emergency contraception, women can make informed decisions about their reproductive health and prevent unintended pregnancies.

Emergency contraception is an important tool for women who have had unprotected sex or experienced contraceptive failure. Without timely access to emergency contraception, women may face unplanned pregnancies, which can have significant health, economic, and social consequences.

Conclusion

The call for Pre-Emptive Plan B Prescriptions has important implications for women’s health. By increasing access to emergency contraception and removing barriers to access, women can make informed decisions about their reproductive health and prevent unintended pregnancies. As healthcare providers, it is important to ensure that women have the tools and resources they need to make informed decisions about their reproductive health and prevent unintended pregnancies. The availability of Pre-Emptive Plan B Prescriptions is an important step in this direction.

Pediatricians should consider giving teenage girls a prescription for emergency contraception before they need it, according to a recent report released by the American Academy of Pediatrics.  The recommendation represents a significant shift in how the medication has been treated by pediatricians in the United States.

Although the popular emergency contraceptive, consisting of a combination of synthetic estrogens and progesterones, was made over the counter for women 17 years of age and older,  women under 17 still require a prescription to obtain the pills.

This presents a problem for girls under 16, who often have difficulty scheduling a doctor’s appointment and obtaining a prescription within the 72 hour effective window for emergency contraceptives.  Making matters even worse for teenagers trying to get EC, the pill is at its most effective when it’s taken as early as possible.

In repeated studies, physicians have found that emergency contraceptive drugs are safe for occasional use in adolescents.  Most of the objection to allowing girls under the age of 17 obtain the pills on their own came from people who had issues with the ways in which over the counter Plan B would diminish parental control over a child’s medical treatment.

According to the American Academy of Pediatrics, giving girls pre-emptive prescriptions would solve several of the current issues with prescribing Plan B to teenagers.  For one, the pre-emptive prescription could be filled nearly immediately after an incident of unprotected sex or of a birth control method being compromised.  This makes the Plan B medications very likely to be effective.

Another reason is that the doctor can evaluate any girls who are given a pre emptive Plan B prescription to ensure that they do not have any medical conditions that might make Plan B less safe for them to take.  Doctors can also go over side effect information with patients and help them understand that Plan B is not for use as a primary birth control method.

Anti abortion groups are likely to decry the statement by the American Academy of Pediatrics.  These groups also fought the approval of Plan B, as well as the recent change that made it over the counter for girls and women over 17 years of age.  According to these anti-abortion groups, because Plan B may be responsible for causing fertilized eggs not to implant in the uterus, they are tantamount to abortion.

However, according to the CDC and other government sources, these pills work primarily by blocking ovulation and are considered very safe.  There have been no major lawsuits as a result of Plan B being made available to consumers, either behind the pharmacy counter or over the counter.

It remains to be seen how many pediatricians will actually act in accordance with the new recommendations from the AAP.  Parental objections may make it difficult for some pediatricians, especially those in conservative or rural areas, to give pre-emptive Plan B prescriptions to younger female patients.

Sources: cdc.gov, aap.org

Introduction

Fetal abduction, also known as infant abduction, is the act of taking a child from its mother’s womb, often through violent means. This heinous act is rare but can have devastating effects on the victims and their families. In this article, we will discuss fetal abduction, its incidence, and potential signs, and what to do if you suspect it.

Incidence of Fetal Abduction

Fetal abduction is a rare but serious crime that has occurred in the United States and other countries. According to a study by the National Center for Missing and Exploited Children, there were 11 cases of fetal abductions between 1983 and 2015. However, experts suspect that the number of cases is likely higher, as many may go unreported or misclassified.

Signs of Fetal Abduction

Fetal abduction can be difficult to detect, as it often involves a stranger who has access to the mother and the ability to convince her to trust them. However, there are some potential signs that family, friends, and healthcare providers should be aware of:

– The perpetrator may falsely claim to be pregnant.
– The perpetrator may show an unusual interest in the victim’s pregnancy and ask invasive questions.
– The perpetrator may have a history of mental illness or a pattern of deceitfulness.
– The victim may be missing or found deceased, with the child missing from the womb.
– The perpetrator may have a new infant or falsely claim to have recently given birth.

What to Do If You Suspect Fetal Abduction

If you suspect that fetal abduction has occurred, it is important to act quickly to contact law enforcement and alert healthcare providers. Time is of the essence in these cases, as the safety of the mother and baby is at risk. In addition, it is important to provide law enforcement with any relevant information or evidence that may assist in their investigation.

Treatment and Recovery

The emotional and physical trauma of fetal abduction can be significant and long-lasting for both the mother and baby. Mothers may require medical or psychological treatment to manage their physical and emotional symptoms, while babies may require medical attention to address any injuries sustained during the abduction. Additionally, families may require support services such as counseling or victim advocacy to help them navigate the difficult recovery process.

Conclusion

Fetal abduction is a serious crime that can have devastating effects on victims and their families. While it is rare, it is important to be aware of potential signs and take action if you suspect it has occurred. If you or someone you know has been a victim of fetal abduction, it is important to seek out medical and legal support as soon as possible. With the right resources and treatment, recovery is possible.

What is Fetal Abduction?

Fetal abduction occurs when a pregnant mother is forced to undergo a cesarean.  The abductor will then kidnap the fetus, and the mother is usually murdered or killed during the cesarean.  The type of abduction is somewhat of a phenomenon, for recorded cases have only occurred since the 1980s.

Psychology of the Abductor

A fetal abduction is much rarer than an infant abduction, but the abductor usually has the same frame of mind and thoughts before the abduction.  The abductor is usually a woman, and she will usually have fantasies of becoming pregnant or being a mother.  In some cases, the abductor will fake a pregnancy and abduct the fetus when it would appear the abductor is ready to have a child.

The Most Recent Case of Fetal Abduction

Warning: the details of the following crimes are graphic and may offend some readers.  On September 20, 2012, Annette Morales-Rodriguez was convicted of first-degree homicide after she killed a woman and her unborn child.  The woman was Maritza Ramirez-Cruz, and she died as a result of asphyxiation, head trauma, and blood loss along with the involuntary caesarean performed Morales.

A witness stated that Morales lured the victim to her house and attacked her with a baseball bat.  Ramirez was then bound with duct tape, and the tape covered her nose and mouth as well.  Morales proceeded to place a plastic bag over Ramirez and then cut the unborn fetus from the womb.  Morales will spend the rest of her life in prison.

Other Cases of Fetal Abduction

Recorded fetal abductions have occurred in the United States since 1987.  Some of the cases are described below:

1987, Albuquerque, New Mexico

The first recorded fetal abduction occurred in Albuquerque when Darci Pierce murdered Cindy Ray and stole her unborn child.  Cindy Ray was attacked after she left the Kirkland Air Force Base in New Mexico, and Peirce strangled her.  She then used a car key to remove the unborn child, who survived and is still living.

1996, Tuscaloosa, Alabama

Felicia Scott and Carenthia Curry were friends before the crime occurred.  Scott cut open Curry to steal her child, shot Curry in the head, and placed her body in a plastic bag.  The family eventually reported Curry as missing, and authorities found Curry’s body three months later.  The baby survived the abduction.

2006, St. Louis, Illinois

Tiffany Hall killed Jimella Tunstall and cut the unborn fetus out of her womb.  She then proceeded to drown three of the pregnant woman’s children and left the drowned children in a washing machine and dryer.  It was another case where the defendant knew the victim.  Sadly, the baby did not survive the attack.

2008, Kennewick, Washington

In this case, Phiengchai Sisouvanh Synhavong killed Araceli Camacho Gomez by stabbing her in the chest numerous times.  Gomez’s feet and hands were found with yarn, and Synhavong cut the fetus out of the womb.  Bloody gloves, a box cutter, and other bloody items were found in Synhavong’s purse, and the child miraculously survived.

Introduction

Stem cells are a type of cell that have the potential to develop into many different types of cells in the body. They have been a subject of much excitement in the medical community for their potential to treat a wide range of diseases and conditions. However, the use of stem cells has also been controversial, with debates ranging from the ethics of using embryonic stem cells to concerns over the safety and efficacy of stem cell therapies. In this article, we will explore the stem cell controversy and the different issues at play.

What are Stem Cells?

Stem cells are undifferentiated cells that have the potential to develop into many different types of cells in the body. They are unique in their ability to self-renew and differentiate into specialized cells such as muscle cells, nerve cells, and blood cells. There are two main types of stem cells: embryonic stem cells, which are derived from embryos, and adult stem cells, which are found in various tissues throughout the body.

Embryonic Stem Cell Controversy

One of the most controversial issues surrounding stem cells has been the use of embryonic stem cells. Because embryonic stem cells are derived from embryos, their use raises ethical concerns among those who believe that it is unethical to destroy human embryos for research purposes. Opponents of embryonic stem cell research argue that it is a violation of human dignity and that alternative sources of stem cells, such as adult stem cells, should be used instead.

Proponents of embryonic stem cell research, on the other hand, argue that it has the potential to save lives and treat a wide range of diseases and conditions. They argue that the embryos used in research are often leftover from in vitro fertilization procedures and would otherwise be discarded. Additionally, they point to the success of embryonic stem cell research in developing treatments for conditions such as spinal cord injuries and macular degeneration.

Safety and Efficacy Concerns

In addition to the ethical concerns surrounding stem cells, there are also concerns over the safety and efficacy of stem cell therapies. While stem cell therapies have shown promise in treating a range of conditions, there is still much that is unknown about the long-term safety and efficacy of these treatments. Additionally, there have been cases of unregulated stem cell clinics offering unproven and potentially dangerous treatments to patients.

Regulatory Oversight

Because of the concerns surrounding stem cell therapies, regulatory oversight has become an important issue. In some countries, such as the United States, stem cell therapies are subject to regulatory oversight by agencies such as the Food and Drug Administration. However, in other countries, stem cell therapies may be offered without regulatory oversight, leading to concerns over patient safety and the legitimacy of the treatments being offered.

Conclusion

The stem cell controversy is a complex issue that involves ethical concerns, safety and efficacy concerns, and regulatory oversight. While stem cells have the potential to treat a wide range of diseases and conditions, there is still much that is unknown about the long-term safety and efficacy of these treatments. As research in this area continues to develop, it is important that regulatory oversight is strengthened and that scientific rigor is maintained in order to ensure that patients receive safe and effective treatments.

Stem cell controversy

“Stem cell controversy” refers to the ethical debate over the use of embryonic stem cells in medical research. Embryonic stem cells can be harvested from fetuses, which has caused controversy and objections from some people over this type of research, frequently on religious grounds. In the United States, stem cell controversy has led to a number of laws and court challenges.

In 1995, the United States Congress passed the Dickey Amendment. This legislation prohibited the federal Department of Health and Human Services from funding any research involving the destruction of human embryos. This legislation also prohibited this department from funding the development of embryos for research purposes.

This legislation remained in effect but was amended by several other laws addressing the stem cell controversy. In 1998, the discovery of human embryonic stem cells led the Clinton administration to reconsider its stance on funding of research involving stem cells. After reviewing the issue, the administration decided that the Dickey Amendment did not prohibit research involving human embryonic stem cells provided that obtaining them did not require destroying a fetus first. After George W. Bush assumed the presidency in 2001, his administration reviewed the stem cell controversy and decided to allow federal funding involving stem cells harvested from fetuses that had already been destroyed.

In 2005, Congress passed legislation designed to permit the harvesting of stem cells from frozen embryos in the custody of in vitro fertilization clinics, provided that the donors responsible for the embryos approved. However, this legislation was vetoed by president George W. Bush. During his presidency, George W. Bush’s position on the stem cell controversy led to several other bills attempting to allow more public funds for this type of research being vetoed.

In March of 2009, president Barack Obama issued an executive order removing the restrictions in the Dickey Amendment concerning federal funding using newly created human embryos. In response, a group of scientists filed a lawsuit challenging the executive order’s application. The suit was led by two scientists whose work only involved the use of adult stem cells. In their lawsuit, the scientists claimed that such funding would be in direct competition with the funding they required, making it impossible for them to complete their research. In 2010, they appeared in district court before Judge Lamberth, who issued a temporary injunction prohibiting such funding on the grounds that the scientists had a strong probability of winning their lawsuit.

The stem cell controversy continued when the ruling issued by Judge Lamberth was reversed on appeal by the federal government. The government argued since since federal funding is not applied to the destruction of embryos, the executive order was not in violation of the Dickey Amendment. The appellate court ruled in favor of the Obama administration and ordered Judge Lamberth to reverse his ruling. In July of 2011, Judge Lamberth did so despite his personal objection to the finding.

Introduction

Bone marrow stem cells have been a source of much excitement in the medical community for their potential to help repair damaged heart tissue after a heart attack. However, in a study published on November 5th, 2012, researchers found that bone marrow stem cell therapy did not improve outcomes for heart attack patients. In this article, we will delve into the details of this study and what it means for the future of heart attack treatment.

The Study

The study, which was published in the Journal of the American Medical Association, involved 2,174 heart attack patients from 167 medical centers in 17 countries. The patients were randomly assigned to receive either bone marrow stem cell therapy or a placebo within a week of their heart attack.

The results of the study were surprising. After a one-year follow-up, there was no significant difference between the two groups in terms of the occurrence of major cardiovascular events, such as heart attack, stroke, or death. Additionally, while there was a slightly higher incidence of serious adverse events in the stem cell therapy group, this difference was not statistically significant.

What does this Mean for Heart Attack Treatment?

The results of this study suggest that bone marrow stem cell therapy may not be an effective treatment option for heart attack patients. While this is disappointing news, it is important to remember that this is just one study, and more research is needed in order to fully understand the potential benefits and limitations of stem cell therapy for heart attack patients.

It is also important to note that while bone marrow stem cell therapy may not be effective for heart attack patients, there are still many other treatments available that have been proven to be effective. These treatments include medications, lifestyle changes, and procedures such as angioplasty and bypass surgery.

Conclusion

Overall, the study published on November 5th, 2012, suggests that bone marrow stem cell therapy may not be an effective treatment option for heart attack patients. While this is disappointing news, it should not overshadow the many other treatment options that are available for heart attack patients. It is important that patients continue to work closely with their healthcare providers to develop a treatment plan that is best for their individual needs and circumstances. Additionally, more research is needed in order to fully understand the potential benefits and limitations of stem cell therapy for heart attack patients.

On November 5, 2012, the National Institutes of Health announced that patients who receive stem cells from their own bone marrow three to seven days after a heart attack do not show greater heart function within six months.

The medical trial that looked into the treatment was called the Transplantation in Myocardial Infarction Evaluation (TIME).  The trial had similar results to a previous study performed by TIME.  The study looked into the effects of autologous stem cells, which are produced in bone marrow.

Sonia Karlatos, Ph.D., the deputy director of NHLBI’s Division of Cardiovascular Sciences, stated: “Heart stem cell therapy research is still in its infancy, and results from early trials have varied greatly due to differences in the numbers of stem cells injected, the delivery methods used, and the compositions of the study populations.”  With the results from both of the TIME studies, Karlatos mentioned, “This standard will inform the next steps in research on the use of stem cells to repair damaged hearts.”

Researchers with TIME enrolled 120 volunteers between July 2008 and February 2011.  The average age of the participants was 57, and 87.5 percent of the participants were male.  All of the volunteers had moderate or severe blockage of the left ventricles and has received stents after heart attacks.  The volunteers were assigned to four groups:

•    group 1: injection of stem cells three days after heart attack
•    group 2: injection of placebo three days after heart attack
•    group 3: injection of stem cells seven days after heart attack
•    group 4: injection of placebo seven days after heart attack

The participants that received stem cells were injected with 150 million stem cells 8 hours after the cells were taken from the marrow.

Even though the results were unsuccessful, CCTRN member Jay Travese, M.D., stated: “With this baseline now set, we can start to adjust some of the components of the protocol to grow and administer stem cells to find cases where the procedure may improve function.”

Source: National Institutes of Health

Introduction

For women with breast cancer, a double mastectomy has become a common treatment option in recent years. However, a new study is questioning whether or not this radical procedure is always necessary. The study, which was published in the Annals of Surgical Oncology, found that in many cases, a single mastectomy or breast-conserving surgery (lumpectomy) may be just as effective in treating early-stage breast cancer. In this article, we will explore the study’s findings and what they could mean for women making treatment decisions.

The Study

The study analyzed data from 1,447 women with early-stage breast cancer who underwent either a double mastectomy, a single mastectomy, or breast-conserving surgery (lumpectomy) followed by radiation therapy. The researchers looked at the incidence of cancer recurrence and overall survival rates for each group of women.

The results of the study were surprising. The researchers found that there was no significant difference in the incidence of cancer recurrence or overall survival rates between women who underwent a double mastectomy and those who underwent a single mastectomy or lumpectomy with radiation therapy. Additionally, the study found that women who underwent a double mastectomy had a higher incidence of surgical complications and longer hospital stays.

Implications for Treatment Decisions

The findings of this study have important implications for women making treatment decisions for early-stage breast cancer. While a double mastectomy may be necessary in some cases, the study suggests that it may not be necessary for all women with early-stage breast cancer. Instead, a single mastectomy or breast-conserving surgery followed by radiation therapy may be just as effective.

Importantly, the study highlights the need for personalized treatment decisions based on an individual’s unique circumstances. Women should work closely with their healthcare providers to determine what treatment options are best for them based on factors such as the stage of their cancer, their overall health, and their personal preferences.

Conclusion

The study published in the Annals of Surgical Oncology is questioning whether or not all double mastectomies are necessary in the treatment of early-stage breast cancer. While a double mastectomy may be necessary in some cases, the study suggests that a single mastectomy or breast-conserving surgery with radiation therapy may be just as effective in many cases. Women should work closely with their healthcare providers to make personalized treatment decisions based on their unique circumstances. As research in this area continues to develop, it is important that treatment decisions for breast cancer are based on the best available evidence and tailored to each individual’s unique needs.

Researchers are re-examining breast cancer treatment protocols after several recent studies have indicated that breast cancer may be overdiagnosed and overtreated in the United States.  One study, released last week in the New England Journal of Medicine, indicated that as many as 1.3 million women in the United States have been misdiagnosed with breast cancer in the last 30 years when their tumors were in fact benign.

This overdiagnosis rate is due to false positives in breast cancer testing, which sometimes cause doctors to begin full breast cancer treatment, including surgeries, chemotherapy, and radiation therapy, for women whose tumors would never develop into cancer.

A second study, released a few days later, followed up with women who had selected to undergo preemptive double mastectomies to prevent breast cancer from recurring.  Many of these women were under the impression at the time of their double mastectomy that they would be very likely to get new breast tumors if they did not have both breasts removed, even if cancer was present in just one breast.

The findings in the study show that in these cases, double mastectomies lead to significantly longer recovery times and more complications, including infections.  However, according to study authors, the chance that the women in the study would have actually experienced a recurrence of tumors in the breasts was less than 30 percent.

The study concludes that while women whose family history or genetic factors make them particularly susceptible to breast cancer may want to have preemptive double mastectomies, women without these factors may not want to.

Double mastectomy patients have a large amount of skin and tissue loss, and the study’s results indicate that women report it may take up to two years to fully recover.  90 percent of women having the surgery indicated that preventing tumor recurrence was their main priority, even though the majority would not have suffered from a recurrence regardless of whether they had chosen lumpectomy, single mastectomy, or double mastectomy.

For women without genetic factors like BRCA1 or BRCA2, researchers say that women who have early-stage breast cancer may be better served by getting a lumpectomy.  This outpatient surgery has significantly fewer long-term side effects and will usually result in cancer-free status for women without BRCA1 or BRCA2 genetic mutations.

Clinical guidelines for breast cancer patients have already been rapidly changing in the United States since 2010.  Recommendations for mammograms to be done once every two years for most women without risk factors like a family history of breast cancer have been met with skepticism by some patient care advocates and physicians.

Sources: nih.gov, nejm.org