ROX Cancer Center Beverly Hills Mammogram Party 2013

ROX Beverly Hills Mammogram Party

Why?

Brush up your on breast cancer knowledge and stay up to date with current screening recommendations when you join us Tuesday April 2, 2013 for our first annual ROX Cancer Center Beverly Hills Mammogram Party. Current recommendations by the American Cancer Society are for women to begin screening mammograms at age 40 (earlier for some patients with a strong family history of breast cancer). However, almost one third of eligible women fail to complete this very simple annual screening test. Meet with the experts, including breast oncologist Dr. Travis Kidner to learn more and assess your own risk.

Recommendations:

1) Women under age 40

2) Women 40 years and older

3) Women at HIGH RISK

4) Women with Breast Implants

Where? 465 North Roxbury Drive, Beverly Hills, CA 90210, suite 1001

When? April 2, 2013, 5:30 to 8:30 P.M

RSVP:  310-777-5400

ROX Center is excited to bring you womens health Beverly Hills. We are proud to announce that ROX Women’s Health Center is now live! The surgeons of ROX Center have developed ROX Women’s Health Center in an effort to expand our committment to surgical excellence to all arenas of a woman’s health. Of course our practice has always brought to you, our patients, excellence in plastic and reconstructive surgical services. With the development of ROX Women’s Health Center, we have expanded our footprint into comprehensive breast care, breast cancer care, and gynecology care.

Additional services provided at ROX Women’s Health Center include: breast reconstruction, Mommy Makeover, tummy tuck, breast augmentation and revision breast surgery.

*photos on this blog post are not actual patients.

Breast cancer and Melanoma still remain significant medical and surgical challenges. No one likes to hear the “C” word, but when you or a family member are faced with any cancer diagnosis, a trusted, experienced doctor is critical. Dr. Travis Kidner is a surgical oncologist and a general surgeon, certified by the American Board of Surgery. He discovered a passion for the care of cancer patients at the University of Cincinnati while working in the research lab0ritories and has specialized in it for nearly a decade.

As part of the team of highly skilled doctors and plastic surgeons, including Dr. Jay Calvert, Dr. Kevin Brenner and Dr. Andrew Ordon of the ROX Center group in Beverly Hills, he specializes in all types of surgical oncology but focuses on breast cancer and melanoma patients.

According to BreastCancer.org, a center for breast cancer research, about 1 in 8 U.S. women (just under 12%) will develop invasive breast cancer over the course of her lifetime. Dr. Travis Kidner has treated hundreds of women facing this harrowing disease and has the expertise and education to back it up.

Upon reviewing his extensive resume and training, you’ll be assured you or your family member will be in good hands when with Dr. Kidner. Upon completion of his medical degree, Dr. Kidner began his General Surgery training at Emory University in Atlanta, Georgia. After two years of training, he was accepted into the Research Fellowship Program at Memorial Sloan-Kettering Cancer Center in New York City. While in New York, Dr. Kidner worked alongside the world’s experts in cancer treatment and new research. He then completed his General Surgery training at Cedars-Sinai Medical Center in Los Angeles, California.

Dr. Kidner was then accepted into the Surgical Oncology Fellowship training program at one of the best cancer research hospitals on the West Coast, the John Wayne Cancer Institute in Santa Monica, California. While there he perfected his surgical skills and trained alongside medical and radiation oncologists to provide a multidisciplinary approach in the treatment of cancer.

He is a member of American College of Surgeons and Society of Surgical Oncology and holds many awards and honors as well as a published author in The American Journal of Surgery, The American Surgeon, and Journal of the American College of Surgeons, among others.

If you or a family member is in need of one of the best oncologists in Los Angeles, Dr. Travis Kinder is here to help. He performs outpatient surgical procedures at The ROX Center in Beverly Hills, California. In addition, Dr. Kidner is a member of the medical staff at Cedars-Sinai Medical Center.

Join TEAM ROX for the STOP CANCER 5K/10K Run.

5K/10K RUN/WALK

JOIN TEAM ROX CENTER on Sunday October 7th as we walk to support STOP CANCER. This year, Dr. Brenner is proud to serve on the SC board of directors this year and is extremely excited that ROX CENTER will be supporting this worthy cause yet again. If you and your family cannot make it to the race, then consider supporting TEAM ROX with a donation. For those of you running, do not forget to stop by the ROX tent and pick up some ROX Water before the race begins.

About STOP CANCER

ROX Water

STOP CANCER has funded over 167 grants to 129 researchers with support valued at over $54 million dollars for cancer research. Every grant that they make is matched with in-kind support from the recipient cancer center. SC helps to support research for many areas of interest, including skin cancer, breast cancer and lung cancer.

STOP CANCER research grants elevate and expose young researchers to opportunities for growth, discovery and collaboration. Seed funding is crucial. A grant allows scientists to begin their research. Without seed funding, researchers would not be able to receive the attention and necessary support of additional funding that leads to major cancer achievements.

So, please join TEAM ROX CENTER and come out to run or walk this very important 5K/10K event.

ROX CENTER SUPPORTS STOP CANCER

Breast Cancer Awareness Month October 2011

In honor of breast cancer awareness month, this year Surgical Friends Foundation will chose one patient to undergo a life changing free breast reconstructive surgery.

If you or someone you know has previously undergone treatment for breast cancer and is currently uninsured, you may qualify to receive free breast reconstructive surgery.

Patient criteria include:

1. Previously treated for breast cancer

2. Has not had any previous breast reconstructive surgery

3. Uninsured (i.e lacks health insurance)

4. Demonstrate financial need

5. Submit the application by July 1^st 2011. Email applications to applications@surgicalfriends.org or mail application to the following address:

Surgical Friends Foundation*  Attn: Breast Cancer * 465 N. Roxbury Dr. Suite 1001* Beverly Hills, CA 90210

Note: due to limitations of funds and resources only one applicant will be chosen.  Chosen applicant will be contacted on or before July 31^st 2011. Surgery will be scheduled prior to October 2011 in honor of breast cancer awareness month.

*photos on this post are not actual patients of Dr. Brenner.

breast calcifications on mammogram

The use of a patient’s own fat for augmentation and fill (autologous fat grafting) has gained popularity in recent years. Autologous fat grafting is a very useful procedure, in particular for augmentation of the facial skeleton, and buttocks (Brazilian butt lift) during cosmetic and reconstructive procedures. The use of autologous fat grafting is a successful progression from our success and refinement of liposuction techniques. Outside of the United States, plastic surgeons have begun using fat grafting for augmentation of the breast as well. However, plastic surgeons within the U.S. have not yet begun utilizing fat grafting to the breast for cosmetic purposes , instead reserving it as a secondary procedure in reconstruction cases following mastectomy.

While very useful, one of the risks of fat grafting is the development of fat necrosis. Fat necrosis is a condition where fat cells die off as a result of being deprived of adequate blood supply. While some fat cells will liquify and dissolve, others will heal in through the process of scar formation. Although rarely visible, this scar formation can present as a palpable lump. Further, during the process of fat necrosis, small calcifications can form within the scar tissue. This can be problematic should it occur in the breast because it interferes with our ability to properly perform screening mammography since calcifications that result from fat necrosis appear similar to calcifications that occur with some breast cancers.

A recent study in Beijing reviewed just this topic (Wang, et al. Plast Recon Surg. Vol 127, No.4 April, 2011, p1669). This group evaluated 48 patients who had undergone cosmetic autologous fat injection for breast augmentation over a ten year period. Eight of these patients (16.7%) developed microcalcifications on their mammogram. These calcifications were highly suspicious for breast carcinoma, obligating all of the women to a breast biopsy procedure. Although the pathological evaluation found fat necrosis (and not carcinoma) in these specimens, these eight women required a surgical procedure in order to adequately evaluate their breast and rule out the possibility of carcinoma.

MRI for breast reconstruction

As a  Board Certified Los Angeles Plastic Surgeon, I care for a wide array of different types of breast patients. My patient population includes women who present requesting breast augmentation, breast lifting, breast reduction, and breast reconstruction. In fact, I also operate on many patients years after they have had their initial post-mastectomy breast reconstruction to “tune-up” their results for such problems as breast scarring, breast implant malposition, breast implant hardening from capsular contracture, and age-related changes to the breast. One of the most common questions that I am asked regards the indications and need for MRI (magnetic resonance imaging) in these patients.

MRI is useful for several purposes in cosmetic patients who have had silicone breast implants placed.  This includes evaluation for implant shell integrity(implant rupture), as well as evaluation of the breast tissue itself when it is unable to be visualized on standard mammography.

However, the use of MRI in breast cancer patients who have already undergone mastectomy procedures (in particular bilateral mastectomy, with breast  reconstruction) has been controversial. Recently, a group of breast surgeons from the Saul and Joyce Brandman Breast Cancer Center at Cedars-Sinai Medical Center reviewed just this issue (Vandewalde, et al., The American Surgeon, Vol 77, No. 2, February 2011, p180.) In this observational study, 48 patients were reviewed. Sixty-eight of 79 breast MRIs (86%) showed benign findings.  Two MRIs (2%) confirmed malignancy in patients with highly suspicious physical examination findings. Three MRIs (4%) led to additional imaging tests that proved to be benign. There were no patients with local breast cancer recurrence detected by these MRI exams that were not already evident on physical examination. Three quarters of the MRIs ordered were ordered for post-operative surveillance only. Six MRIs (8%) showed residual breast tissue, although most of the reports did not comment  on presence or absence of breast tissue in these patients. Ultimately, this study found inadequate evidence to support the use of MRI as a routine surveillance tool after mastectomy and reconstruction.  However, more studies will likely need to be done, in particular to evaluate the use of MRI to evaluate changes in autologous tissue flaps (ie. the patients’ own tissue) used in breast reconstruction.

Breast Implants Safe

ASPS and FDA Collaborate to help establish a new Breast Implant Registry:

The American Society of Plastic Surgeons (ASPS) is establishing a national registry for breast implants in collaboration with the Food and Drug Administration (FDA). The registry is being developed in response to reports of a rare lymphoma–Anaplastic Large Cell Lymphoma (ALCL)-in a very small number of women with breast implants.

The ASPS and the FDA agree this extremely rare form of lymphoma is not breast cancer. There are an estimated 10 million breast implants worldwide and there have been only 34 cases of ALCL  identified over the last twenty-two years. Lymphomas can appear anywhere in the body. However, this lymphoma subset appears to arise  in the scar tissue that forms around the breast implants. At this time both the FDA and ASPS remain confident that breast implants are safe and effective.

According to the FDA report:

“Based on available information, it is not possible to confirm with statistical certainty that breast implants cause ALCL. At this time, data appear to indicate that the incidence of ALCL is very low, even in breast implant patients. Currently it is not possible to identify a type of implant (silicone versus saline) or a reason for implant (reconstruction versus aesthetic augmentation) associated with a smaller or greater risk.”

According to Phillip Haeck, MD, ASPS President, “the ASPS shares the FDA’s commitment to patient safety, but we also want to make certain this information does not raise false alarms with our patients. We’ve been down this path before.  For nearly 20 years American women were denied access to their choice of breast implants because of false claims and unfounded science. We are determined this shouldn’t happen again. A woman with breast implants has about the same chance of being hit by lightning as she does coming down with this condition,” he added”

Recommendations for all patients with breast implants have not changed. ASPS recommends that women with breast implants should continue their normal routine in medical care and follow-up, specifically regular self examination and mammography when appropriate.  As I have always recommended to my patients, anyone who notes new changes in their breasts or around their breast implants (i.e. pain,  swelling, hardening) should contact our offices at 310-777-5400.

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. They have  more than 7,000 physician members. The ASPS is the leading authority and information source on cosmetic and reconstructive plastic surgery. My commitment as a member of  ASPS is to relay important findings and updates from the ASPS to my patients.

Resources:

FDA medical device safety advisory

FDA ALCL preliminary findings

occult breast cancer

In 2008, nearly 90,000 women in the United States underwent breast reduction surgery. During a similar 12 month period in 2009, over 192,000 American women were diagnosed with new breast cancers. Occasionally, these two groups of patients overlap. In other words, some women first learn of and are first diagnosed with breast cancer only after their breast reduction tissue specimens are examined and noted by the pathologist to contain breast cancer cells. These cases represent unsuspected carcinoma in breast reduction specimens (their pre-operative mammograms were normal), also known as occult breast cancer. In several recent studies, occult breast cancer occurs in between 0.06 and 4 percent of breast reduction specimens.  In breast cancer patients who have never undergone breast reduction surgery, breast conservation (i.e. lumpectomy and radiation) is frequently possible for early tumors (nearing 80%) since the tumor location within the breast is known, and the surgical margins are usually demonstrative. However, when a tumor is incidentally noted in a surgical breast specimen, localizing the tumor area can become somewhat of a challenge. This often obligates patients to mastectomy in order to ensure adequate removal of the tumors. A recent study (PRS  Vol 127, No 2, Feb 2011 p525) presented a simple system of surgical specimen markings that helps permit breast-conserving treatments should an occult carcinoma be identified in a breast reduction specimen. Although this technique will not completely eliminate the need for completion mastectomy in some patients, using it can potentially increase the number of patients who would be eligible for breast conservation.

What patient characteristics fair the best with breast reconstruction?

Early detection and treatment of breast cancer in recent years has led to a longer survival of these patients. This in turn has led to an increased interest in the quality of life of breast cancer survivors. Although there is a paucity of literature about this facet of breast reconstruction, a newly published study looks at ‘quality of life’ parameters. According to a new study, certain personality traits are linked to higher quality-of-life scores in breast cancer patients who undergo breast reconstruction after mastectomy. (Plastic & Reconstructive Surgery. 127(1):10-17, January 2011)

The study investigators gave a battery of psychological tests to 57 women with breast cancer who underwent mastectomy and immediate breast reconstruction. The goal was to look at how various personality dimensions and patterns of interpersonal functioning affected quality of life after surgery.

After adjustment for other factors, two personality types were linked to higher quality-of-life scores. This included women with high scores for the temperamental characteristic of “harm avoidance” (i.e. patients who may be apprehensive and doubtful). For these patients, the authors note that restoration of their body image could help to reduce social anxiety and insecurity.

Patients rated as “vindictive/self-centered” on a scale of interpersonal problems also had higher quality-of-life scores. These type of patients may be  resentful and aggressive. For many of them, the complete process of breast reconstruction might symbolize the conclusion of a reparative process and fulfill the desire of a “revenge on cancer.”

None of the other psychological or other factors evaluated including the characteristics of the cancer and its treatment were significantly related to quality-of-life scores. Overall, mastectomy followed by breast reconstruction yielded significant improvement in quality of life.

As survival rates improve, there is increased attention to the quality of life in breast cancer survivors. More women are undergoing breast reconstruction immediately after mastectomy, which seems to reduce the psychological impact of treatment. This new study is one of the first to look at how personality factors might affect patient satisfaction and quality of life after mastectomy and breast reconstruction. The results suggest that some personality characteristics have an important impact on psychological recovery after breast cancer treatment. This is likely true not only for patients who choose to have immediate breast reconstruction with autologous tissue or with tissue expanders, but also for patients that desire revision of previous sub-optimal breast reconstruction.

Thank you to all of my friends, family and patients who have reached out thus far and donated to help support me in this upcoming adventure. If you have not yet been able to do so, now is a great opportunity to help.

STOP CANCER is very excited to announce Armie Hammer, co-star of the hit movie The Social Network, as the Honorary Chair of the STOP CANCER 5K Run/Walk!

Armie has a special connection to STOP CANCER.  In 1988, his late great-grandfather, Dr. Armand Hammer founded STOP CANCER in partnership with Sherry Lansing, former head of Paramount Pictures.  The dedication, the enthusiasm and the perseverance that Dr. Hammer brought to the mission of STOP CANCER inspire today’s indomitable volunteers to help fulfill his dream of a cure for cancer in our lifetime.

“My great-grandfather, the late Dr. Armand Hammer, believed cancer research was vital to end cancer.   I’m proud to be part of this 5K Run/Walk to help raise awareness and funds for this critical research.” said Armie.

JOIN US!  Run/walk with Armie to make a difference in the fight to STOP CANCER.

The Run/Walk just keeps getting better!  Stay tuned for more exciting announcements as we get closer!

DATE/TIME:            Sunday, December 5^th, 8:00 am

LOCATION:             Woodley Park, 6350 Woodley Ave., Van Nuys, CA 91406

To Learn More:

In partnership with STOP CANCER, I.C.O.N./Cure for a Cause and Krav Maga Worldwide/The Marni Fund will be holding a 5K Run/Walk with proceeds benefiting cancer research at UCLA, USC and City of Hope Comprehensive Cancer Centers.

The collaboration of a rapidly growing international hair care products company, a unique and world-renowned self-defense organization, all in partnership with STOP CANCER, serves as an extraordinary demonstration of the success of fundraising partnerships to accomplish an enormously important mission: developing new therapeutics, diagnostic procedures and the ultimate goal … a cure for a disease that touches so many lives.

As part of STOP CANCER’s unique arrangement with the three NCI-designated Comprehensive Cancer Centers, each Research Award granted to scientists is matched by each of these institutions in the form of in-kind support, effectively doubling its value.

As a Board-Certified Plastic Surgeon, every week I enjoy helping cancer patients rebuild and restore their lives through reconstructive plastic surgery. I am proud to be a member of STOP CANCER, a wonderful organization that is helping attack cancer on a whole new level.  If you would like to support me, or even better join me in this most worthy charitable endeavor, please visit the respective links to learn more.

Your charitable donation can help amplify my hard work.

Thank you,
Kevin Brenner, MD, FACS

So here is what you need to know about routine breast cancer screening:

1. Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health.

2. Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional, at least every 3 years.

3. Breast self exam (BSE) is an option for women starting in their 20s.

4. Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year.

5. Age 50 as a starting point for mammography screening has been proven unfounded.

Reconstructed Nipple-Areola

There is no questions that nipple-areolar reconstruction should be an integral part of breast reconstruction for mastectomy patients. Although it is possible to restore a breast mound with either tissue-expander/implant-based reconstruction or with autologous soft tissue flaps, a realistic appearing nipple-areola is what lends identity to a woman’s breast. Although nipple reconstruction is frequently the last stage in breast reconstruction, its completion confers a distinct psychological benefit to breast cancer patients.  Once patients have had a breast removed, they are reminded daily of this unfortunate loss every time that they undress and look in the mirror. Completion of their breast reconstruction with creation of a nipple-areolar complex is an important step toward feeling “whole” again. The more realistic the breast reconstruction (including a nipple-areolar complex) appears, the more likely it these patients will experience a feeling of relief from this great loss.

If you are a breast cancer survivor in Los Angeles or around the country, it is important to realize that breast reconstruction almost always occurs in stages. Re-creating a realistic appearing breast is a true surgical challenge, and one that I take great pleasure in performing. A symmetric breast mound must first be created, and allowed ample time to heal. Once this has occurred, we can begin planning the final stage which consists of nipple-areolar reconstruction.

Right Breast Melanoma

Melanoma of breast skin accounts for <5% of all malignant melanomas, and large series of primary breast skin melanoma are particularly rare . The surgical treatment of primary cutaneous malignant melanoma of the breast is challenging, but actually there is no significant difference between melanoma of breast skin and melanoma of other skin parts .  Wide local excision of the primary site and sentinel lymph node biopsy are frequently sufficient as surgical treatments. If lymph node involvement in the armpit is detected, clinically (on physical examination) or pathologically(on biopsy of tissues), lymph node dissection should also be performed. The photo shown above was a very unusual, very advanced tumor. Treatment in this case was palliative  and required mastectomy and chest wall reconstruction.

Tumors metastatic to the breast are quite unusual, but malignant melanoma is an exception.

In any cutaneous melanoma case with a palpable breast mass, mammography and/or ultrasonography should be obtained to reveal the number of metastatic lesions. Following confirmation of histological diagnosis by fine needle aspiration cytology (FNAC), WLE or quadrantectomy is sufficient for surgical treatment in cases with no evidence of multiple metastatic lesions.