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Breast cancer can spread to the chest wall. It is an aggressive stage of poor prognosis. We have developed a technique of major chest wall resection extended beyond the breast area in order to reduce the recurrence.This is a retrospective single-center series of 33 patients with breast cancer spread to the chest wall without metastasis (13 patients present with primary breast cancer and 20 patients present with recurrent breast cancer) treated by major chest wall resection between January 1993 and January 2013, by the same surgeon. Analysis of the results was made by another surgeon.Patients aged between 27-83years with an average of 55years. The removed parts measured 350cm(2) to 1200cm(2), and the average duration of complete healing was 7.9months. The mean follow-up time was 122months (6months-240months). The 1 year survival was 84.4%, at 2years 72.6%, at 3years 69.5% and at 5 years of 66.4%.The technique of major chest wall resection is simple and reproducible. Breast cancer with chest wall extension has a poor prognosis. At the end of the study, 20 of 33 patients who benefit from this technique are still alive.

The authors report a very rare case of necrobiosis lipoidica, histopathologically confirmed, which happened in the breast a few months following the insertion of a silicone implant (post-mastectomy reconstruction). This case raises two problems: the physiopathology (role of the silicone implant) and the treatment of this accident, resistant to current therapy.

The authors report a very rare case of lipome extended to the superficial and deep lobes of parotid gland. MRI remains the best complementary examination to direct the diagnosis; however only the surgery will bring a histological proof formal.

Israeli families who immigrate to the United States present certain sociocultural issues that need to be recognized in order to provide culturally relevant, respectful and empowering mental health counseling. Israeli families are further situated within the complex social, cultural, economic and political context of Jews in the United States, who are themselves rarely recognized as a minority group. The purpose of this article is to present some major themes observed in working with Israeli families. A brief case example and analysis are presented, along with some general guidelines for counselors working with Israeli families.