Outcomes in chest feminization patients with a history of illicit hormone use and silicone injections

2021 ◽  
Vol 27 (4) ◽  
pp. 352-358
Author(s):  
Abigail R. Tirrell ◽  
Areeg Abu El Hawa ◽  
Jenna C. Bekeny ◽  
Gabriel Del Corral
Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Monik C Jimenez ◽  
JoAnn E Manson ◽  
Kathryn M Rexrode

Introduction: Low dehydroepiandrosterone sulfate (DHEAS) levels recently have been related to elevated risk of ischemic stroke. However, the association between DHEAS and traditional cardiovascular risk factors remains unclear. Methods: Blood samples were collected in 1989-1990 among 32,826 participants of the Nurses’ Health Study. Samples were assayed for DHEAS, lipids, and other biomarkers as part of a nested case control study evaluating risk of ischemic stroke and 340 stroke-free controls with complete data were available. Lifestyle covariates were ascertained in 1988. Stepwise logistic regression models were used to evaluate the association of between CVD risk factors and low DHEAS (<42 μ g/dL), while stepwise linear regression was used to evaluate the association with continuous DHEAS. Stepwise models utilized an entry threshold of α=0.20 and exit criterion of α=0.10. Results: The mean level of DHEAS was 78.38 μ g/dL (s.d. 50.02; median=67.03) in this population of women aged 43-69 years (median=62). Age was strongly associated with lower DHEAS. Women with history of heart disease and higher total/HDL cholesterol were more likely to have low DHEAS. In stepwise logistic regression analyses, age (OR=2.94; 95%CI: 1.73-5.00 for 10 yrs) and history of heart disease (OR=1.84; 95% CI: 0.91-3.70) were identified as risk factors for low DHEAS. In stepwise linear regression modeling, age, postmenopausal hormone use, history of heart disease and C-reactive protein (CRP) were associated with lower DHEAS levels while alcohol use was associated with higher DHEAS levels (Table 1). Body mass index, smoking, diabetes, glycosylated hemoglobin and lipids were not associated with low DHEAS. Conclusions: In this population of healthy women, lower levels of DHEAS were associated with older age, history of heart disease, postmenopausal hormone use, higher CRP and lower levels of alcohol consumption. Further research is needed to explore these associations. Table 1 Multivariable * adjusted estimates for DHEAS by cardiovascular disease risk factors DHEAS (continuous μ g/dL) β † 95%CI Age ‡ −28.40 −36.75, -20.05 History of Heart disease −18.76 −39.23, 1.71 Postmenopausal Hormone Therapy Use & −12.01 −21.99, -2.04 CRP £ (mg/L) −0.66 −1.37, 0.04 Alcohol # (g/day) 2.95 0.46, 5.45 * All variables mutually adjusted for one another † Estimated from stepwise logistic regression model ‡ per 10 year increase in age & Ref = No use of postmenopausal hormone therapy £ per 1 unit increase in C-reactive protein (CRP- mg/L) # per 5 unit increase in alcohol consumption (g/day)


2009 ◽  
Vol 13 (10) ◽  
pp. 1540-1545 ◽  
Author(s):  
Johanna M Meulepas ◽  
Polly A Newcomb ◽  
Andrea N Burnett-Hartman ◽  
John M Hampton ◽  
Amy Trentham-Dietz

AbstractObjectiveMultivitamin supplements are used by nearly half of middle-aged women in the USA. Despite this high prevalence of multivitamin use, little is known about the effects of multivitamins on health outcomes, including cancer risk. Our main objective was to determine the association between multivitamin use and the risk of breast cancer in women.DesignWe conducted a population-based case–control study among 2968 incident breast cancer cases (aged 20–69 years), diagnosed between 2004 and 2007, and 2982 control women from Wisconsin, USA. All participants completed a structured telephone interview which ascertained supplement use prior to diagnosis, demographics and risk factor information. Odds ratios and 95 % confidence intervals were calculated using multivariable logistic regression.ResultsCompared with never users of multivitamins, the OR for breast cancer was 1·02 (95 % CI 0·87, 1·19) for current users and 0·99 (95 % CI 0·74, 1·33) for former users. Further, neither duration of use (for ≥10 years: OR = 1·13, 95 % CI 0·93, 1·38, P for trend = 0·25) nor frequency (>7 times/week: OR = 1·00, 95 % CI 0·77, 1·28, P for trend = 0·97) was related to risk in current users. Stratification by menopausal status, family history of breast cancer, age, alcohol, tumour staging and postmenopausal hormone use did not significantly modify the association between multivitamin use and breast cancer.ConclusionsThe current study found no association between multivitamin supplement use and breast cancer risk in women.


2015 ◽  
Vol 48 (03) ◽  
pp. 317-320 ◽  
Author(s):  
Theddeus Octavianus Hari Prasetyono ◽  
Patricia Marcellina Sadikin

ABSTRACTEven though Silicone injection for breast augmentation has been related to disastrous long-term effects and complications, some patients do not develop significant symptoms at all (asymptomatic). Unfortunately, the management of asymptomatic Silicone-injected breast is still unclear and has never been reported exclusively. We present two cases of asymptomatic patients with a history of liquid Silicone injections who refused to have a mastectomy. They were concerned with the breast ptosis and chose to undergo reduction mammoplasty to improve the appearance of the breasts. Magnetic resonance imaging may be useful as an additional screening tool to confirm the diagnosis and exclude the presence of malignancy in breasts with injected Silicone. We believe that breast reduction may be the alternative option for women with a history of liquid Silicone injection who have no symptoms but desire to preserve their breasts and improve their aesthetics.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. TPS1597-TPS1597
Author(s):  
Etta Pisano ◽  
Constantine Gatsonis ◽  
Martin Yaffe ◽  
Melissa Troester ◽  
Ilana F Gareen ◽  
...  

TPS1597 Background: This randomized trial is intended to determine whether tomosynthesis (TM) should replace the current standard for breast cancer (BC) screening, digital mammography (DM). It is hypothesized that the population of women assigned TM screening for 3-5 rounds will have fewer advanced cancers than the population assigned to DM screening. Methods: 164,946 women, ages 45 to 74 years who present for screening mammography and consent to participate will be enrolled across 150 sites in the US, Canada and abroad. Women will be randomized to TM or DM. The frequency and number of screening examinations over a five year period will vary based on menopausal status and whether they have specific risk factors, including - hormone use, family history of BC, deleterious genes, prior benign breast biopsy with diagnosis of LCIS or atypia any kind, or dense breasts. Blood and buccal cells will be collected from as many enrolled women as are willing to provide the samples. All breast biopsies during the trial will undergo gene expression analysis for the PAM50 and other progression pathways (PAM50-plus). All subjects enrolled will be followed long term for at least eight years. The primary endpoint is the proportion of participants who have an advanced breast cancer diagnosed at any time within 4.5 years of randomization in to the trial. Secondary endpoints include measures of diagnostic and predictive performance; rates of recall, biopsy, and interval cancers, prevalence of breast cancer subtypes, and tumor subtype based on PAM50-plus analysis. As of January 17th 2020, there are 104 sites open and 21,452 women enrolled in the trial. The DSMC last reviewed the trial in June 2019 and suggested that the trial continue as planned. Clinical trial information: NCT03233191.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Deirdre K. Tobias ◽  
Aditi Hazra ◽  
Patrick R. Lawler ◽  
Paulette D. Chandler ◽  
Daniel I. Chasman ◽  
...  

Abstract Obesity is a risk factor for > 13 cancer sites, although it is unknown whether there is a common mechanism across sites. Evidence suggests a role for impaired branched-chain amino acid (BCAAs; isoleucine, leucine, valine) metabolism in obesity, insulin resistance, and immunity; thus, we hypothesized circulating BCAAs may be associated with incident obesity-related cancers. We analyzed participants in the prospective Women’s Health Study without a history of cancer at baseline blood collection (N = 26,711, mean age = 54.6 years [SD = 7.1]). BCAAs were quantified via NMR spectroscopy, log-transformed, and standardized. We used Cox proportional regression models adjusted for age, race, smoking, diet, alcohol, physical activity, menopausal hormone use, Body Mass Index (BMI), diabetes, and other risk factors. The endpoint was a composite of obesity-related cancers, defined per the International Agency for Research on Cancer 2016 report, over a median 24 years follow-up. Baseline BMI ≥ 30 kg/m2 compared with BMI 18.5–25.0 kg/m2 was associated with 23% greater risk of obesity-related cancers (n = 2751 events; multivariable HR 1.23, 95% CI 1.11–1.37). However, BCAAs were not associated with obesity-related cancers (multivariable HR per SD = 1.01 [0.97–1.05]). Results for individual BCAA metabolites suggested a modest association for leucine with obesity-related cancers (1.04 [1.00–1.08]), and no association for isoleucine or valine (0.99 [0.95–1.03] and 1.00 [0.96–1.04], respectively). Exploratory analyses of BCAAs with individual sites included positive associations between leucine and postmenopausal breast cancer, and isoleucine with pancreatic cancer. Total circulating BCAAs were unrelated to obesity-related cancer incidence although an association was observed for leucine with incident obesity-related cancer.


2021 ◽  
Vol 9 ◽  
pp. 232470962110512
Author(s):  
Ashley Bray ◽  
Jonathan Vincent M. Reyes ◽  
Nancy Tarlin ◽  
Aaron Stern

Hypercalcemia is one of the most commonly encountered laboratory abnormalities in clinical medicine. Various causes have been well established. However, it is likely that the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may be a newly found cause of this frequent finding, especially amongst those with a history of cosmetic surgery, specifically by means of silicone injection. In this case series, we describe 2 patients presenting with symptomatic hypercalcemia likely from their prior silicone injections. Interestingly, each patient only developed symptoms of hypercalcemia following infection with SARS-CoV-2.


2004 ◽  
Vol 128 (5) ◽  
pp. 561-564
Author(s):  
Lisa A. Laird ◽  
James S. Hoffman ◽  
Aziza Omrani

Abstract We describe a case of multifocal polypoid endometriosis presenting with advanced bulky disease at a variety of pelvic sites. The extent of tumor and clinical features such as vaginal bleeding and pulmonary embolus were suggestive of a malignant process. Histopathology demonstrated glands that were neither crowded nor complex, with intervening fibromatous stroma that contained occasional endometrial stromal cells. These features were consistent with the newly described condition of polypoid endometriosis. Despite the endometrioid appearance of this tumor, there was florid ciliary cell change. An association has been suggested between polypoid endometriosis and prior tamoxifen use, although this patient had no history of prior hormone use.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Patrick R Lawler ◽  
Akintunde O Akinkuolie ◽  
Paul M Ridker ◽  
Allan D Sniderman ◽  
Robert J Glynn ◽  
...  

Background: There remains equipoise as to which plasma lipid/lipoprotein marker most accurately reflects longitudinal risk of coronary heart disease (CHD) events. To compare differences in risk related to nonHDLc (atherogenic particle cholesterol) and LDL particle number (LDLp) or apoB (atherogenic particle number), we examined risk when these markers were discordant. Methods and Results: We divided 27,533 initially-healthy women in the Women’s Health Study (NCT00000479) into concordant/discordant groups based on median nonHDLc (154 mg/dL) and apoB (100 mg/dL) or 1 H NMR-measured LDLp (1,216 nmol/L). Discordance was defined as nonHDLc < median and the alternative measure ≥ median, or vice versa. We compared risks between concordant and discordant groups (using the concordant group as reference) with Cox proportional hazard models adjusted incrementally for: age; and randomization arm, hormone use, postmenopausal status, smoking, and hypertension (“minimally adjusted”); and diabetes, BMI, hsCRP, HDLc, triglycerides, and family history of CHD (“fully adjusted”). Although all 3 biomarkers were strongly correlated - nonHDLc and apoB (Spearman r=0.86, P<0.0001), nonHDLc and LDLp (r=0.77, P<0.0001), and apoB and LDLp (r=0.85, P<0.0001) - discordance between nonHDLc and apoB or LDLp occurred in 13.9% and 20.2% of women, respectively. A total of 1,246 CHD events occurred over median (max) 20.4 (21.7) years of follow-up (514,725 person-years). With nonHDLc < median (Fig. a), CHD risk was underestimated among women with discordant high apoB or LDLp: fully adjusted HR (95% CI) high apoB = 1.33 (1.04, 1.71); high LDLp = 1.27 (1.01, 1.61). Alternately, with nonHDLc ≥ median (Fig. b), CHD risk was overestimated among women with discordant low apoB or LDLp: fully adjusted HR [95% CI] low apoB = 0.74 (0.57, 0.96); low LDLp = 0.93 (0.76, 1.14). Conclusions: For women with discordant levels of nonHDLc with apoB or LDLp, CHD risk may be underestimated or overestimated with nonHDLc.


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