Over the last 100 years, numerous types of implants (i.e. ivory, glass, wool) and injections (i.e. epoxy resin, beeswax, paraffin) have been used in an attempt for breast augmentation but the results were poor. In 1962, the first operation using silicone implants was performed and it revolutionised breast surgery. Breast augmentation surgery (cosmetic and reconstructive) is one of the most common cosmetic surgeries in Australia, United States, and the United Kingdom.

As one of the most common cosmetic surgeries, it is important for doctors and patients to know about the risks and myths of this procedure. In this episode, we discuss breast augmentation surgery and our discussion includes common complications, risks, and breast implantation illness.

This is the story of breast augmentation

Our special guest:

Our special guest is plastic surgeon Dr Andrew Campbell-Lloyd from ACL Plastic surgery in Adelaide.

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The interplay between genetics and medications is important but complex. Pharmacogenomic testing provides doctors with information about how individual patients may respond to certain medications (ie. fast and slow metabolisers).

The RCPA recently released guidelines for doctors about requesting patient pharmacogenomic testing before prescribing some medications. These guidelines have identified 35 medications into three pharmacogenomics testing categories: recommend, consider, and no consensus. We discuss this testing with our guest today.

This is the story of pharmacogenomics.

RCPA guidelines: https://www.rcpa.edu.au/Library/Practising-Pathology/Pharmacogenomic-Indications-in-Australia

Our special guest:

Our special guest is Professor Luke Hessen who is the manager of the Genetics Department at Douglass Hanly Moir and co-Chair of the RCPA Pharmaogenetic Advisory Group.

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In 1924, a surgeon and a pathologist had a conversation about some patients with multiple bowel polyps. The pathologist, Dr Cuthbert Dukes, and the surgeon, Mr JP Lockhart-Mummery, noted that patients had a family history of bowel cancer and could have hundreds of colonic polyps. They, with the help of HRJ Bussey, set up the Polyposis Registry.

The registry collected information about these patients and the families from 1918 to 1954. They found that patients developed polyps in childhood, the risk of affected children was 50%, and cancer took 15 years to develop from first diagnosis. This was clearly a familial disease.

Today, we know this a Familial Adenomatous Polyposis or FAP. The genetic basis for this condition was identified in the 1980s and 1990s. Professor Sir Walter Bodmer led a team to map the location of the Adenomatous Polyposis Coli (APC) gene involved.

This is the story of Familial Adenomatous Polyposis (FAP)

Our special guests:

Professor Sir Walter Bodmer is a professor of the Cancer and Genetics laboratory and Department of Oncology at Oxford University. Areas of research include: HLA, population genetics, Human Genome Project, and mapped the APC gene. He was knighted in 1986.

Dr Tristan Rutland is an Anatomical Pathologists, recipient of the Konrad Muller RCPA Outstanding Teaching Award (2020), and recipient of the Resident Advocate Award from the College of American Pathologists.

Dr Emelia Ip is a trained medical oncologist, staff specialist in cancer genetics, and co-chair of EviQ Adult Cancer Genetics Reference Committee.

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