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https://www.readbyqxmd.com/read/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#1
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28643329/analgesic-plasma-concentrations-of-oxycodone-after-surgery-for-breast-cancer-which-factors-matter
#2
K Cajanus, M Neuvonen, O Koskela, M A Kaunisto, P J Neuvonen, M Niemi, E Kalso
We investigated factors affecting analgesic oxycodone concentrations after breast cancer surgery in 1,000 women. Preoperatively, we studied heat and cold pain sensitivities and anxiety scores. Postoperatively, rest and motion pain intensities were measured and intravenous oxycodone was administered until satisfactory analgesia. At this point, the mean oxycodone concentration (variation coefficient) was 33.3 ng/ml (66%), and it was 21.7 ng/ml (69%) when the patient requested oxycodone again. At both time points, the concentrations varied >100-fold between individuals...
June 23, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28629690/axillary-lymph-node-sonographic-features-and-breast-tumor-characteristics-as-predictors-of-malignancy-a-nomogram-to-predict-risk
#3
Patricia Akissue de Camargo Teixeira, Luciano F Chala, Carlos Shimizu, José R Filassi, Jonathan Y Maesaka, Nestor de Barros
The purpose of this study was to build a mathematical model to predict the probability of axillary lymph node metastasis based on the ultrasonographic features of axillary lymph nodes and the tumor characteristics. We included 74 patients (75 axillae) with invasive breast cancer who underwent axillary ultrasonography ipsilateral to the tumor and fine-needle aspiration of one selected lymph node. Lymph node pathology results from sentinel lymph node biopsy or surgical dissection were correlated with lymph node ultrasonographic data and with the cytologic findings of fine-needle aspiration...
June 16, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28626128/a-case-of-matrix-producing-carcinoma-of-the-breast
#4
Yuzuru Inoue, Fumi Joden, Kei Yabuki, Nagahiro Sato, Noritaka Minagawa, Takefumi Katsuki, Norihiro Sato, Takahisa Nagata, Kazunori Shibao, Atsuji Matsuyama, Takatoshi Aoki, Keiji Hirata
A 61-year-old woman was referred to our hospital because of a right breast mass. A 19 mm hard mass was palpable in the A area of the right breast. A contrast-enhanced MRI showed rim enhancement at the peripheral region of the tumor, which was thought to represent the carcinoma component mainly at the periphery and the matrix component inside the tumor. A low density mass with rim enhancement at the peripheral region was observed in a contrast-enhanced CT, the same as in the MRI. Neither axillary lymph node metastasis nor distant metastasis was observed...
2017: Journal of UOEH
https://www.readbyqxmd.com/read/28625445/prospective-double-blind-randomized-placebo-controlled-clinical-trial-of-the-pectoral-nerves-pecs-block-type-ii
#5
Barbara Versyck, Geert-Jan van Geffen, Patrick Van Houwe
STUDY OBJECTIVE: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. DESIGN: A prospective randomized double blind placebo-controlled study. SETTING: A secondary hospital. PATIENTS: 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28623243/metaplastic-breast-carcinoma-with-chondroid-differentiation-a-rare-variant-of-infiltrative-carcinoma-in-a-38-year-old-woman
#6
Shokouh Taghipour Zahir, Mostafa Javannejad
Metaplastic breast carcinoma (MBC) is a rare type of invasive breast carcinoma, and chondroid differentiation is even rarer. Here we report a case of MBC with extensive chondroid differentiation in a 38-year-old woman who presented with a lump in her left breast. Ultrasound findings were most compatible with those of giant fibroadenoma. A histopathological examination revealed a malignant lesion comprising neoplastic epithelial cells arranged in solid nests, with large areas of chondroid differentiation. Neoplastic chondroid cells exhibited a positive reaction for S-100, patchy positive reaction for pan-cytokeratin (AE1/AE3) and negative reaction for epithelial membrane antigen...
June 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28621194/-breast-reconstruction-surgery-with-endoscopic-assisted-latissimus-dorsi-muscle-flap
#7
Gábor Bognár, András Novák, György Ledniczky, Gábor István
The results obtaining with breast reconstruction surgery are not always satisfactory for the patients. Reconstruction with pure latissimus dorsi flap is useful option and due to endoscopic harvest large scar on the back can be avoided. The skin sparing mastectomy and even the sentinel lymph node biopsy or lymphadenectomy can be performed using a single incision in the axilla. Also the immediate reconstruction with endoscopically assisted harvest of the latissimus dorsi muscle flap in selective cases can be done using the same incision...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28608612/factors-impacting-the-accuracy-of-intra-operative-evaluation-of-sentinel-lymph-nodes-in-breast-cancer
#8
Catherine L Akay, Constance Albarracin, Tiffany Torstenson, Roland Bassett, Elizabeth A Mittendorf, Min Yi, Henry M Kuerer, Gildy V Babiera, Isabelle Bedrosian, Kelly K Hunt, Rosa F Hwang
Sentinel lymph node dissection (SLND) is a standard axillary staging technique in breast cancer and intraoperative sentinel lymph node (SLN) assessment is important for decision-making regarding additional treatment and reconstruction. This study was undertaken to investigate clinicopathologic factors impacting the accuracy of intraoperative SLN evaluation. Records of patients with clinically node-negative, invasive breast cancer who underwent SLND with frozen section intraoperative pathologic evaluation from 2004 to 2007 were reviewed...
June 13, 2017: Breast Journal
https://www.readbyqxmd.com/read/28608456/is-axillary-surgery-beneficial-for-patients-with-adenoid-cystic-carcinoma-of-the-breast
#9
Jessemae L Welsh, Michael G Keeney, Tanya L Hoskin, Katrina N Glazebrook, Judy C Boughey, Sejal S Shah, Tina J Hieken
BACKGROUND AND OBJECTIVES: Adenoid cystic carcinoma (ACC) is a rare, typically triple-negative, breast cancer reported to have a favorable prognosis and low rate of nodal metastasis. No consensus guidelines exist for axillary staging and treatment. METHODS: We identified all patients with ACC evaluated at our institution from January 1994 to August 2016. Patient, tumor, and treatment variables were abstracted and analyzed. RESULTS: We identified 20 pure ACCs (0...
June 12, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28604321/sentinel-lymph-node-biopsy-and-neoadjuvant-chemotherapy-in-the-management-of-early-breast-cancer-safety-considerations-and-timing
#10
Jenny Edge, Sarah Nietz
Over the last decades, breast cancer treatment has become more personalised. Treatment plans are based on the biology of the tumour rather than the stage. Consequently, neoadjuvant chemotherapy (NACT) is commonly the primary therapy for early breast cancer as well as locally advanced disease. Sentinel lymph node biopsy (SLNB) is standard axillary management for women with node-negative disease. This review looks at the relevant literature and gives guidance on the timing of SLNB when NACT is planned and evaluates the safety of performing an SLNB rather than an axillary clearance...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28602450/pain-sensory-disturbances-and-psychological-distress-among-danish-women-treated-for-ductal-carcinoma-in-situ-an-exploratory-study
#11
Birgitte Goldschmidt Mertz, Helle M Duriaud, Niels Kroman, Kenneth G Andersen
Ductal carcinoma in situ is a noninvasive precancer condition. The treatment resembles the treatment of invasive breast cancer. The aim of this exploratory study was to gain knowledge on the level of postoperative pain, sensory disturbances, and distress among a small group of Danish women with ductal carcinoma in situ who had sentinel lymph node biopsy in order to plan a population study. A subgroup of patients with ductal carcinoma in situ (n = 20) was compared to patients with invasive breast cancer (n = 455) at time of diagnosis and after 12 months...
June 8, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28601382/long-term-follow-up-of-node-negative-breast-cancer-patients-evaluated-via-sentinel-node-biopsy-after-neoadjuvant-chemotherapy
#12
Hiroko Nogi, Ken Uchida, Rei Mimoto, Makiko Kamio, Hisashi Shioya, Yasuo Toriumi, Masafumii Suzuki, Eijiro Nagasaki, Tadashi Kobayashi, Hiroshi Takeyama
BACKGROUND: Sentinel node biopsy (SNB) is used to accurately assess axillary lymph node status in patients with node-negative breast cancer. However, its use after neoadjuvant chemotherapy (NAC) is controversial. We retrospectively assessed the usefulness of SNB after NAC by comparing axillary recurrence rates and other parameters in patients with clinically node-negative breast cancer who underwent SNB after NAC or without NAC. PATIENTS AND METHODS: At our hospital, 1179 patients with clinically node-negative breast cancer underwent SNB from April 2007 to December 2013...
May 8, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28600146/surgical-staging-of-the-axilla-is-it-on-its-way-out-a-retrospective-study-and-review-of-the-literature
#13
Debkumar Chowdhury, Ionela Drehuta, Sanjeet Bhattacharya
INTRODUCTION: Sentinel lymph node biopsy (SLNB) is the reference standard for axillary staging in all patients with invasive breast cancer. Surgical practices are being reviewed for a more conservative approach to the axilla. PATIENTS AND METHODS: In this audit, we studied the incidence of axillary disease in patients with ultrasound negative axilla. The selection criteria are similar to an ongoing national study: female patients, age > 50 years, primary breast lesion < 1...
May 19, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28597470/breast-conservation-for-male-breast-cancer-case-report-of-intraoperative-radiation
#14
Ameer Gomberawalla, Peter Liou, Rebecca Martinez, Raj Rajpara, Eileen Connolly, David Horowitz, Sheldon Feldman
Male breast cancer (MBC) comprises <1% of all breast cancers in the United States. MBC is typically treated with total mastectomy while the majority of female breast cancer is treated with breast conservation therapy combined with various forms of radiation. One method that has developed over the last two decades is the use of intraoperative radiation therapy (IORT) as a type of accelerated partial breast irradiation to direct the treatment field to the tumor bed. Since overall prognosis and systemic therapy recommendations for MBC are similar to breast cancer in women, we describe the first case of MBC treated with BCS and IORT...
June 8, 2017: Breast Journal
https://www.readbyqxmd.com/read/28597050/is-there-a-role-for-sentinel-node-biopsy-in-the-pre-operative-ultrasound-positive-axilla
#15
EDITORIAL
M Ahmed, F Jozsa, M Douek
Axillary management in breast cancer is becoming increasingly conservative. This approach is based on the identification of low axillary burden on sentinel node biopsy (SNB). The modern practice of routine pre-operative axillary ultrasound has meant that patients are 'fast tracked' to axillary node clearance (ANC) in the presence of a histologically confirmed positive axilla. This practice reduces the number of patients undergoing SNB compared to the original trials, which evaluated the role of SNB, and those assessing safety of omission of ANC in low axillary burden...
June 8, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28585745/sentinel-node-biopsy-for-early-breast-cancer-in-queensland-australia-during-2008-2012
#16
Paramita Dasgupta, Philippa H Youl, Christopher Pyke, Joanne F Aitken, Peter D Baade
BACKGROUND: Sentinel node biopsy (SNB) is now the standard of care for women with early-stage breast cancer. Despite lower morbidity than axillary lymph node dissection, widespread variation in SNB rates by non-clinical factors persists. We explored the factors associated with SNB usage and changes in those associations over time for recently diagnosed women. METHODS: We report here on a linked population-based cancer registry and hospital inpatient admission data set for 5577 women aged at least 20 years diagnosed with a first primary invasive early-stage node-negative breast cancer from July 2008 to 2012 in Queensland, Australia, who underwent breast cancer-related surgery within 2 years of diagnosis...
June 6, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28585003/secondary-breast-carcinoma-after-completely-remitted-chronic-myeloid-leukemia-following-targeted-tyrosine-kinase-inhibitor-therapy
#17
Linlin Pan, Junwu Duan, Weiqiang Qiao, Lirong Bi, Di Wu, Zhimin Fan, Ming Yang
We describe a rare case of secondary breast carcinoma after chronic myeloid leukemia (CML) in a 56-year-old woman. The patient was treated with hydroxyurea and imatinib for CML and achieved complete remission (she has since been taking imatinib as the maintenance therapy). Four years later, the patient noticed a firm and painless lump in the left breast, which was diagnosed as ductal carcinoma in situ based on a percutaneous biopsy of the mass. Simple resection and sentinel lymph node biopsy of the left breast were then performed...
June 5, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/28584266/novel-rapid-immunohistochemistry-using-an-alternating-current-electric-field-for-intraoperative-diagnosis-of-sentinel-lymph-nodes-in-breast-cancer
#18
Kaori Terata, Hajime Saito, Hiroshi Nanjo, Yuko Hiroshima, Satoru Ito, Kasumi Narita, Yoichi Akagami, Ryuta Nakamura, Hayato Konno, Aki Ito, Satoru Motoyama, Yoshihiro Minamiya
Axillary lymph node status and pathological diagnosis of sentinel lymph nodes (SLNs) is a prognostic factor that influences management of postoperative therapy. Recent reports indicate that one-step nucleic acid amplification and hematoxylin and eosin (HE)-stained frozen sections are effective for intraoperative diagnosis of SLNs. In the present study, we report a rapid-immunohistochemical staining (R-IHC) method that enables intraoperative detection of SLN metastases within 16 min using an anti-cytokeratin antibody...
June 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28576464/prognostic-impact-of-macrometastasis-linear-size-in-sentinel-node-biopsy-for-breast-carcinoma
#19
M P Foschini, R Miglio, C Quinn, B Belgio, P Regitnig, S Bianchi, R Nannini, H Buerger, H Kaya, I Illyés, J Kulka, C A Wells, J De Gaetano, I Lipeniece-Karele, G Cserni
AIM: The aim of the present study was to evaluate the risk of axillary non-sentinel lymph-node metastases (ALN) in breast cancer patients presenting macrometastasis (Mac-m) in the sentinel lymph node (SN). MATERIALS AND METHODS: A retrospective series of 1464 breast cancers from patients who underwent ALN dissection following the diagnosis of Mac-m in the sentinel node (SN) was studied. In all the cases the MAC-m linear size was evaluated and correlated with presence or absence of non-SN ALN metastases...
May 17, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28576178/updates-in-postmastectomy-radiation
#20
REVIEW
Jean L Wright, Arti Parekh
Although the use of postmastectomy radiation therapy (PMRT) is widely accepted in certain clinical situations, areas of controversy persist for some clinical scenarios. In addition, with significant shifts in the management of breast cancer, including omission of axillary nodal dissection in select sentinel node-positive patients and increased use of neoadjuvant chemotherapy, new clinical challenges have arisen regarding the role of PMRT. This article reviews the data to support current recommendations for postmastectomy radiation and explores areas of controversy and the studies that guide clinicians in these scenarios...
July 2017: Surgical Oncology Clinics of North America
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