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R Ortiz de la Tabla González, P Gómez Reja, D Moreno Rey, C Pérez Naranjo, I Sánchez Martín, M Echevarría Moreno
OBJECTIVE: To compare the analgesic efficacy of continuous interpectoral block (CIPB) compared to intravenous analgesia (IV) after breast surgery. MATERIAL AND METHOD: A prospective, comparative and randomised study of women aged from 18-75years, ASAI-III, operated for breast cancer. In group1 (CIPB) after general anaesthetic, an ultrasound-guided interpectoral catheter was placed and 30mL of 0.5% ropivacaine was administered through it. In the event of an increase in heart rate and blood pressure >15% after the surgical incision, intravenous fentanyl 1μg·kg-1 was administered, repeating the dose as necessary...
April 2018: Revista Española de Anestesiología y Reanimación
Mario Fajardo-Pérez, Ece Yamak Altınpulluk, Javier García-Miguel, Borja Quintana-Gordon
Using a single dose of local anaesthetics has some disadvantages and provides limited analgesia depending on the pharmacokinetic characteristics of the local anaesthetic used. Nevertheless, the use of continuous perineural infusions allows sustained pain control. Ultrasound-guided interpectoral block followed by the placement of catheters in patients undergoing mastectomies with or without lymph node axillary dissections can result in sufficient pain control. We present a case of a 58-year-old woman undergoing mastectomy and axillary clearance who received ultrasound-guided continuous interpectoral block for postoperative analgesia...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
Giulio Francolini, Mette S Thomsen, Esben S Yates, Carine Kirkove, Ingelise Jensen, Egil S Blix, Claus Kamby, Mette H Nielsen, Mechthild Krause, Martin Berg, Ingvil Mjaaland, Andreas Schreiber, Unn-Miriam Kasti, Kristian Boye, Birgitte V Offersen
BACKGROUND AND PURPOSE: To report on a Quality assessment (QA) of Skagen Trial 1, exploring hypofractionation for breast cancer patients with indication for regional nodal radiotherapy. MATERIAL AND METHODS: Deviations from protocol regarding target volume delineations and dose parameters (Dmin, Dmax, D98%, D95% and D2%) from randomly selected dose plans were assessed. Target volume delineation according to ESTRO guidelines was obtained through atlas based automated segmentation and centrally approved as gold standard (GS)...
May 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Brian M Ilfeld
A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim...
January 2017: Anesthesia and Analgesia
Ahmed R Eldesoky, Esben S Yates, Tine B Nyeng, Mette S Thomsen, Hanne M Nielsen, Philip Poortmans, Carine Kirkove, Mechthild Krause, Claus Kamby, Ingvil Mjaaland, Egil S Blix, Ingelise Jensen, Martin Berg, Ebbe L Lorenzen, Zahra Taheri-Kadkhoda, Birgitte V Offersen
BACKGROUND AND PURPOSE: To internally and externally validate an atlas based automated segmentation (ABAS) in loco-regional radiation therapy of breast cancer. MATERIALS AND METHODS: Structures of 60 patients delineated according to the ESTRO consensus guideline were included in four categorized multi-atlas libraries using MIM Maestro™ software. These libraries were used for auto-segmentation in two different patient groups (50 patients from the local institution and 40 patients from other institutions)...
December 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Pauliina Wright, Sami Suilamo, Paula Lindholm, Jarmo Kulmala
BACKGROUND: In postmastectomy radiotherapy (PMRT), the dose coverage of the planning target volume (PTV) with additional margins, including the chest wall, supraclavicular, interpectoral, internal mammary and axillar level I-III lymph nodes, is often compromised. Electron fields may improve the medial dose coverage while maintaining organ at risk (OAR) doses at an acceptable level, but at the cost of hot and cold spots at the electron and photon field junction. To improve PMRT dose coverage and uniformity, an isocentric technique combining tangential intensity-modulated (IM)RT fields with one medial electron field was implemented...
August 2014: Acta Oncologica
M Wallaert, P Courivaud, E-H Mati, M Shiniara, J-M Guilbert
We describe the case of four patients who had undergone breast surgery. The post-operative analgesia consisted in levobupivacaine administered through a catheter placed between the pectoralis minor and the pectoralis major using ultrasound guided technique. The quality of the analgesia was excellent quality. No side-effects were encountered.
April 2014: Annales Françaises D'anesthèsie et de Rèanimation
Alfredo Carlos S D Barros, Felipe Eduardo M Andrade, José Luiz B Bevilacqua, Maria Aparecida C Barros, José Roberto Piato, Donizeti R Santos, José Roberto Filassi, Cristiane C B A Nimir
AIMS AND BACKGROUND: The extent of axillary lymph node dissection for breast cancer treatment is tailored to each patient. When the surgeon assumes that full dissection, including level III, is needed, there are basically two ways for reaching the apical nodes while preserving the pectoralis muscles: a subpectoral approach, below the joined pectoralis muscles, and another that includes an additional interpectoral dissection between the muscles. We conducted a study to evaluate the radicality of dissection using these two approaches...
July 2013: Tumori
Jin Kyoung Oh, Yong An Chung, Yeon Sil Kim, Hae Myung Jeon, Sung Hoon Kim, Young Ha Park, Soo Kyo Chung
We assessed the role of F-18 FDG PET/CT in evaluating isolated extra-axillary lymph node recurrences in postoperative breast cancer patients and its prognostic value on clinical outcome. We reviewed PET/CT scans of postoperative breast cancer patients performed at our institution between July 2003 and February 2012. We recorded PET/CT findings, clinicopathologic variables and treatment modalities. We analyzed metabolic parameters from PET/CT and clinicopathologic variables with respect to progression free survival (PFS)...
2014: Bio-medical Materials and Engineering
Pedro Coelho Barata, Joana Morgado, Ana Paula Sousa, Sónia Duarte de Oliveira, Maria Paula Custódio, Lígia Bruno da Costa, José Esteves Pena
BACKGROUND: Paraneoplastic neurologic syndromes (PNS) pose quite an uncommon neurological complication, affecting less than 1% of patients with breast cancer. Nearly one third of these patients lack detectable onconeural antibodies (ONAs), and improvement in neurologic deficits with concomitant cancer treatments is achieved in less than 30% of cases. CASE PRESENTATION: A 42-year-old, premenopausal woman presented with facial paralysis on the central left side accompanied by a left tongue deviation, an upward vertical nystagmus, moderate spastic paraparesis, dystonic posturing of the left foot, lower limb hyperreflexia and bilateral extensor plantar reflex...
September 2012: Case Reports in Oncology
O R Brouwer, L Vermeeren, I M C van der Ploeg, R A Valdés Olmos, C E Loo, L M Pereira-Bouda, F Smit, P Neijenhuis, B C Vrouenraets, F Sivro-Prndelj, S M Jap-a-Joe, P J Borgstein, E J Th Rutgers, H S A Oldenburg
PURPOSE: To investigate whether lymphoscintigraphy and SPECT/CT after intralesional injection of radiopharmaceutical into each tumour separately in patients with multiple malignancies in one breast yields additional sentinel nodes compared to intralesional injection of the largest tumour only. METHODS: Patients were included prospectively at four centres in The Netherlands. Lymphatic flow was studied using planar lymphoscintigraphy and SPECT/CT until 4 h after administration of (99m)Tc-nanocolloid in the largest tumour...
July 2012: European Journal of Nuclear Medicine and Molecular Imaging
Jingyan Sun, Jian Yin, Liansheng Ning, Juntian Liu, Hong Liu, Lin Gu, Li Fu
OBJECTIVE: The presence of discontinuous or "skip" metastases in breast cancer is crucial for determining the optimal therapeutic choice. In this study, we compared the clinicopathological characteristics and prognosis of patients with or without skip metastases (SMs). METHODS: We retrospectively analyzed the records of 1,502 breast cancer patients who underwent radical mastectomy and a separate group of 118 patients who had sentinel lymph node biopsies (SLNB). The median follow-up time was 10 years...
February 2012: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Evan I Blumgart, Roger F Uren, Poul M F Nielsen, Martyn P Nash, Hayley M Reynolds
Detailed knowledge of the lymphatic drainage of the breast is limited. Lymphoscintigraphy is a technique used during breast cancer treatment to accurately map patterns of lymphatic drainage from the primary tumour to the draining lymph nodes. This study aimed to create a statistical model to analyse the spread of breast cancer and primary tumour location using a large lymphoscintigraphy database, and visualise the results with a novel computational model. This study was based on lymphoscintigraphy data from 2,304 breast cancer patients treated at the Royal Prince Alfred Hospital Medical Centre in Sydney, Australia...
November 2011: Breast Cancer Research and Treatment
Il Ki Hong, Deog Yoon Kim
We report F-18 FDG PET/CT images of biopsy-proven intramuscular metastasis from primary uterine cervix cancer. A 70-year-old woman was admitted because of a mass in the left axilla. She was diagnosed with uterine cervix cancer and underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic node dissection and received adjuvant chemotherapy and radiation therapy 9 years ago. Magnetic resonance imaging showed a large soft tissue mass in the intramuscular region of the left axilla. The mass showed intense F-18 FDG uptake with a central necrotic portion on F-18 FDG PET/CT...
June 2011: Clinical Nuclear Medicine
Tjeerd S Aukema, Marieke E Straver, Marie-Jeanne T F D Vrancken Peeters, Nicola S Russell, Kenneth G A Gilhuijs, Wouter V Vogel, Emiel J T Rutgers, Renato A Valdés Olmos
PURPOSE: The aim of this prospective study was to assess the incidence of extra-axillary lymph node involvement on baseline FDG PET/CT in patients with stage II-III breast cancer scheduled for neo-adjuvant chemotherapy. METHODS: Patients with invasive breast cancer of >3 cm and/or proven axillary lymph node metastasis were included for before neo-adjuvant chemotherapy. Baseline ultrasound of the infra- and supraclavicular regions was performed with fine-needle biopsy as needed...
December 2010: European Journal of Cancer
A Bricou, Y Delpech, E Barranger
No abstract text is available yet for this article.
February 2010: Gynécologie, Obstétrique & Fertilité
Kenichi Sakurai, Shigeru Fujisaki, Sadanori Matsuo, Michitaka Ogura, Katsuhisa Enomoto, Akira Kitajima, Mayumi Tani, Sadao Amano, Motomi Shiono
We report a case of advanced breast cancer with skin ulceration and bleeding (T4bN3bM0, Stage IIIC) achieving a significant improvement of QOL by paclitaxel (PTX) and toremifene (TOR) therapy. The patient was a 31-year-old woman who had ulcerative breast lump with skin ulcer. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma positive for estrogen receptor and progesterone receptor, and negative for HER2/neu protein expression. She received 4 courses of tri-weekly CEF (C: 500 mg, E: 60 mg, F: 500 mg/m2/tri-weekly) and 4 courses of weekly PTX (80 mg/m2) with TOR (120 mg/day)...
November 2009: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Y M Kirova, P Castro Pena, R Dendale, F Campana, M A Bollet, N Fournier-Bidoz, A Fourquet
PURPOSE: To assist in the determination of breast and nodal volumes in the setting of radiotherapy for breast cancer and establish segmentation guidelines. Materials and methods. Contrast metarial enhanced CT examinations were obtained in the treatment position in 25 patients to clearly define the target volumes. The clinical target volume (CTV) including the breast, internal mammary nodes, supraclavicular and subclavicular regions and axxilary region were segmented along with the brachial plexus and interpectoral nodes...
June 2009: Journal de Radiologie
Alejandro Andrés, Leticia Tardín, Paula Razola, Albert Santapau, Enrique Prats, Ramon Sousa, Fausto García, Javier Banzo
A 57-year-old woman with infiltrating ductal carcinoma of the right breast underwent lymph node scintigraphy with Tc-99m-nanocolloid for preoperative sentinel node localization. On planar images, an unusual pattern of lymphatic drainage was observed. We performed a chest SPECT/CT, revealing an interpectoral sentinel node, ie, Rotter's node. The patient underwent radioguided surgery and the sentinel node was located intraoperatively, and found to be disease-free. SPECT/CT fusion techniques have enhanced precision in locating sentinel nodes, enabling the surgeon to shorten surgical times...
March 2009: Clinical Nuclear Medicine
Kenichi Sakurai, Katsuhisa Enomoto, Mayumi Tani, Akira Kitajima, Sadao Amano, Motomi Shiono
We report a case of advanced breast cancer with skin ulceration and bleeding (T4bN3bM0: Stage IIIC) achieving a significant improvement of QOL by toremifene and paclitaxel therapy. The patient was a 38-year-old woman with slight anemia who had ulcerative breast lump with skin ulcer. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma positive for estrogen receptor and progesteron receptor, and negative for HER2/neu protein expression. She received 6 cycles of tri-weekly FEC (C: 500 mg, E: 60 mg, F: 500 mg/m2) and 16 cycles of weekly paclitaxel (80 mg/m2) with toremifene (120 mg/day)...
November 2008: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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