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BACKGROUND AND OBJECTIVES Accurately assessing breast volume (BV) relative to the volume of breast tissue to be removed could help objectively determine the optimal surgical candidates for breast conserving surgery. The objective of this study was to determine the optimal mammography-based method of BV estimation. METHODS Mammography data was obtained for patients who underwent mastectomy for breast cancer from 2005 to 2015. This data was used to calculate BV using four previously published equations. Results were compared to mastectomy specimen volumes calculated from specimen weights and breast density. Five practitioners then independently assessed reproducibility and ease of use. RESULTS Complete mammographic measurements were available for 65 breasts from 45 patients. Median age was 58 years (range 19-82). Mammographic breast density scores were available for 62 breasts. Of the 65 mastectomies performed, 16 (36%) were simple mastectomies. The equation BV = 1/3πRcc Rmlo Hmlo most closely approximated actual breast specimen volumes (R = 0.89, P

INTRODUCTION: SARS-CoV-2 not only increased the census across all intensive care units at Banner University Medical Center, but also increased total ventilator days and length of stay Tracheostomy was therefore indicated for ventilator dependency for pulmonary toilet, promote liberation from mechanical ventilation and improve bed utilization As SARS-CoV-2 is transmitted primarily through aerosolization, or droplet particles, a tracheostomy in patients with COVID-19 infection infers a substantial risk to the procedural team To mitigate the risk of transmission, we created a multidisciplinary team and modified tracheostomy approach in ventilator dependent COVID 19 patients METHODS: At Banner University Medical Center- Phoenix, a multidisciplinary team including a Medical Intensivist, Trauma and Acute Care Surgeon, Respiratory Therapist, and Anesthesiologist developed a process for placement of surgical tracheostomy via a modified percutaneous approach Three Trauma and Acute Care Surgeons performed all of the MPT at a single institution for ventilator dependent patients with confirmed COVID-19 respiratory failure RESULTS: Between April 2020 and July 2020, 26 patients underwent MPT Sixty-five percent of patients had a positive SARS-CoV-2 RNA nasal swab prior to tracheostomy, while the remaining 35% of patients had a negative or inconclusive COVID-19 test immediately prior to surgery Members of the procedural team;Respiratory Therapist, Operating Room Staff, Anesthesiologist, and Surgeon were interviewed following the procedure No unplanned exposures, such as disconnections in ventilator circuit were reported In addition, to date, no member of the procedural team performing modified percutaneous tracheostomies on COVID-19 positive or recently positive patients have reported a symptomatic coronavirus infection 31% of patients underwent MPT within 20 days of intubation 69% of patients underwent MPT after 20 days of intubation CONCLUSIONS: Using a multidisciplinary approach and standardized process, modified percutaneous surgical tracheostomy can be performed safely on COVID positive patients with minimal risk to the procedural team and performing the procedure within 20 days of intubation while not statistically significant trended towards a decreased average length of stay and mortality