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The American Journal of Case Reports Aug 2020BACKGROUND Breast metastases from melanoma are rare. Amelanotic melanoma is difficult to diagnose, as primary lesions not only lack the pigment typical of melanoma, but...
BACKGROUND Breast metastases from melanoma are rare. Amelanotic melanoma is difficult to diagnose, as primary lesions not only lack the pigment typical of melanoma, but also lack other features associated with these tumors, including asymmetry, irregular borders, and color variegation. CASE REPORT A 58-year-old woman presented with an enlarging mass on her left breast, a finding confirmed by physical examination. Mammography showed a 10-cm breast mass of category 4 according to the Breast Imaging Reporting and Data System (BI-RADS). Staging computed tomography (CT) showed widely scattered metastatic sites in the brain, lungs, mediastinum, and adrenal glands. A biopsy of the mass in her left breast was non-diagnostic due to extensive necrosis. Because of severe pain, simple left breast mastectomy was performed. Tissue from the mastectomy revealed a diagnosis of amelanotic malignant melanoma. CONCLUSIONS Diagnosing amelanotic melanoma is difficult without tissue biopsy as these tumors lack the typical features of melanoma and can mimic other dermatologic diseases. This frequently results in a significant delay in diagnosing amelanotic melanoma, with patients often presenting with advanced stage disease having poor prognosis.
Topics: Breast Neoplasms; Delayed Diagnosis; Female; Humans; Mastectomy; Mastodynia; Melanoma, Amelanotic; Middle Aged; Skin Neoplasms
PubMed: 32756533
DOI: 10.12659/AJCR.921360 -
The British Journal of General Practice... Aug 2020
Topics: Ambulatory Care Facilities; Humans; Mastodynia; Primary Health Care; Referral and Consultation
PubMed: 32732218
DOI: 10.3399/bjgp20X712133 -
Diagnostics (Basel, Switzerland) Jun 2020Breast sonoelastography is a relatively novel ultrasound (US) method that enables estimation of tissue stiffness to estimate the elasticity of normal breast tissue and...
Breast sonoelastography is a relatively novel ultrasound (US) method that enables estimation of tissue stiffness to estimate the elasticity of normal breast tissue and seek to correlate it with well-known breast cancer risk factors. Two hundred women of different age were included in the study and completed a questionnaire about personal, familiar, and reproductive history. Glandular and fatty tissue elasticity in all breast quadrants was measured by shear wave elastography (SWE). Mean elastographic values of breast tissue were calculated and compared to personal history risk factors. Elasticity of normal glandular tissue (66.4 kilopascals (kPa)) was higher than fatty tissue (26.1 kPa) in all breast quadrants and in both breasts. Lower outer quadrant (LOQ) had the lowest elasticity values of both parenchyma and fat. Higher elasticity values of breast tissue were confirmed in the left breast than in the right breast. Glandular and fat tissue elasticity negatively correlated with body mass index (BMI). Women with mastodynia had higher glandular elastographic values compared to subjects without breast pain. Nuliparity was also associated with higher elasticity of glandular breast tissue. The results of this study are promising and could, over time, contribute to a better understanding of glandular breast tissue elasticity as a potential risk factor for breast cancer.
PubMed: 32532143
DOI: 10.3390/diagnostics10060393 -
Rheumatology International Nov 2020Autoimmune syndrome induced by adjuvants (ASIA) is the spectrum of diseases in which the substances considered inert to the body induce autoimmune reactions and...
Autoimmune syndrome induced by adjuvants (ASIA) is the spectrum of diseases in which the substances considered inert to the body induce autoimmune reactions and inflammation. Some of the biomaterials recently used in plastic surgery, such as silicone or polyacrylamide hydrogel (PAAG) seem to trigger clinical features of ASIA. The aim of this study was to assess the incidence of these features within a group of women after breast augmentation with PAAG. As many as 30 consecutive patients (26-59 years, mean age 39.5) referred to the Clinic of Plastic Surgery after breast enhancement with PAAG were examined. The validated criteria of ASIA syndrome were employed. Descriptive statistics were chosen based on the distribution of variables. The research was approved by the Bioethical Committee of the Centre of Postgraduate Medical Education in Warsaw, Poland. Within the studied group, 50% of patients (n = 15) fulfilled ASIA diagnostic criteria. Apart from local complications, we encountered various general symptoms, among which fever (n = 13, 43.3%), tingling and numbness of upper extremities (n = 10, 33.3%) and chronic fatigue (n = 9, 30%) were the most common. These symptoms were present on an ambulatory visit, before qualification to the operation of hydrogel removal. All patients undergoing surgical PAAG removal (n = 8) declared alleviation or complete resolution of the symptoms. Polyacrylamide hydrogel breast filling, although limiting the invasiveness of the procedure in relation to silicone breast implants, also carries the risk of developing ASIA symptoms. The removal of PAAG may bring improvement in some cases.
Topics: Acrylic Resins; Adult; Autoimmune Diseases; Breast; Cosmetic Techniques; Edema; Fatigue; Female; Fever; Humans; Hypesthesia; Incidence; Injections; Mastodynia; Middle Aged; Muscle Weakness; Paresthesia; Poland; Sleep Wake Disorders
PubMed: 32449041
DOI: 10.1007/s00296-020-04605-5 -
Breast Care (Basel, Switzerland) Apr 2020Mastodynia is a subjective symptom that impairs the quality of life. It may be directly related with breast disorders. Moreover, a substantial rate is caused of...
BACKGROUND
Mastodynia is a subjective symptom that impairs the quality of life. It may be directly related with breast disorders. Moreover, a substantial rate is caused of reflective pain.
OBJECTIVES
Non-cyclic mastodynia is multifactorial, and treatment should be planned according to the underlying cause. In this study, we aim to evaluate the existence of cervical discopathy via cervical magnetic resonance imaging (MRI) in the etiology of non-cyclic mastodynia.
METHODS
The study included 60 patients with normal physical examination results and imaging findings. Management was determined individually in patients. Patients with pathological MRI findings were evaluated by physical therapy, rehabilitation, and neurosurgery specialists, and appropriate treatment was planned. Patients were evaluated with the visual analogue scale (VAS) scoring system at initial presentation and after 1 and 3 months of treatment.
RESULTS
The majority of patients had positive findings on MRI (53 [88.4%] vs. 7 [11.6%]). The mean VAS scores at the time of presentation, after 1, and after 3 months of treatment were 7.41, 6.39, and 3.35, respectively. The decrease in the scores was statistically significant ( ≤ 0,01).
CONCLUSIONS
We suggest that cervical discopathy should be kept in mind in cases of idiopathic non-cyclic mastodynia. Furthermore, cervical discopathy-related mastodynia seems to have a good response to appropriate treatment.
PubMed: 32398987
DOI: 10.1159/000501792 -
Strahlentherapie Und Onkologie : Organ... Jul 2020To provide an overview on the available treatments to prevent and reduce gynecomastia and/or breast pain caused by antiandrogen therapy for prostate cancer. (Review)
Review
Treatment strategies to prevent and reduce gynecomastia and/or breast pain caused by antiandrogen therapy for prostate cancer : Statement from the DEGRO working group prostate cancer.
AIM
To provide an overview on the available treatments to prevent and reduce gynecomastia and/or breast pain caused by antiandrogen therapy for prostate cancer.
METHODS
The German Society of Radiation Oncology (DEGRO) expert panel summarized available evidence published and assessed the validity of the information on efficacy and treatment-related toxicity.
RESULTS
Eight randomized controlled trials and one meta-analysis were identified. Two randomized trials demonstrated that prophylactic radiation therapy (RT) using 1 × 10 Gy or 2 × 6 Gy significantly reduced the rate of gynecomastia but not breast pain, as compared to observation. A randomized dose-finding trial identified the daily dose of 20 mg tamoxifen (TMX) as the most effective prophylactic dose and another randomized trial described that daily TMX use was superior to weekly use. Another randomized trial showed that prophylactic daily TMX is more effective than TMX given at the onset of gynecomastia. Two other randomized trials described that TMX was clearly superior to anastrozole in reducing the risk for gynecomastia and/or breast pain. One comparative randomized trial between prophylactic RT using 1 × 12 Gy and TMX concluded that prophylactic TMX is more effective compared to prophylactic RT and furthermore that TMX appears to be more effective to treat gynecomastia and/or breast pain when symptoms are already present. A meta-analysis confirmed that both prophylactic RT and TMX can reduce the risk of gynecomastia and/or breast pain with TMX being more effective; however, the rate of side effects after TMX including dizziness and hot flushes might be higher than after RT and must be taken into account. Less is known regarding the comparative effectiveness of different radiation fractionation schedules and more modern RT techniques.
CONCLUSIONS
Prophylactic RT as well as daily TMX can significantly reduce the incidence of gynecomastia and/or breast pain. TMX appears to be an effective alternative to RT also as a therapeutic treatment in the presence of gynecomastia but its side effects and off-label use must be considered.
Topics: Adenocarcinoma; Anastrozole; Androgen Antagonists; Androgens; Anilides; Antineoplastic Agents, Hormonal; Dizziness; Dose Fractionation, Radiation; Drug Administration Schedule; Estrogen Receptor Modulators; Flushing; Gynecomastia; Humans; Male; Mastodynia; Meta-Analysis as Topic; Neoplasms, Hormone-Dependent; Nitriles; Off-Label Use; Prostatic Neoplasms; Randomized Controlled Trials as Topic; Tamoxifen; Tosyl Compounds
PubMed: 32166452
DOI: 10.1007/s00066-020-01598-9 -
Investigative Radiology Feb 2020The aim of this study was to describe our initial clinical experiences using a dedicated spiral breast computed tomography (B-CT) with a single photon-counting detector.
OBJECTIVES
The aim of this study was to describe our initial clinical experiences using a dedicated spiral breast computed tomography (B-CT) with a single photon-counting detector.
MATERIALS AND METHODS
This retrospective study was approved by the institutional review board. Examinations of 300 consecutive women undergoing B-CT were evaluated on reason of assignment for B-CT instead of mammography, detection rate of breast cancer, and quality criteria of data acquisition. Further evaluated performance indicators were the number of additional ultrasounds examinations due to unclear findings or dense breast tissue and reliability of the technical data acquisition.
RESULTS
Five hundred ninety-one B-CT acquisitions in 300 women were performed. The main reason for preference of B-CT over mammography was the lack of breast compression (254 of 300, 84.7%), which was desired due to personal reasons or mastodynia, whereas 10 patients (0.3%) had implants hampering mammography. One hundred two possible lesions were detected in B-CT including 4 cases of breast cancer (1.3% of all patients). Additional ultrasound was performed in 226 patients (102 due to detected lesions and 124 due to dense breast tissue). Three malignant lesions were only detected in an additional ultrasound (1% of all patients). As a quality criterion, the pectoralis muscle was included in 341 of 591 examinations, but complete assessment of breast tissue was only possible in 149, respectively 140 examinations. No movement artifacts were noted. In 99% of all women, the examination could be realized.
CONCLUSIONS
The dedicated B-CT provides high-quality images. It can be used as alternative particularly in those patients not otherwise willing to perform mammography because of the breast compression.
Topics: Adult; Aged; Aged, 80 and over; Breast; Breast Density; Breast Neoplasms; Female; Humans; Mammography; Middle Aged; Photons; Radiographic Image Interpretation, Computer-Assisted; Reproducibility of Results; Retrospective Studies; Tomography, Spiral Computed
PubMed: 31592797
DOI: 10.1097/RLI.0000000000000609 -
Journal of Menopausal Medicine Aug 2019with the common name of "evening primrose" is containing a valuable fixed oil with commercial name of EPO. Evening primrose oil has two types of omega-6-fatty acid... (Review)
Review
with the common name of "evening primrose" is containing a valuable fixed oil with commercial name of EPO. Evening primrose oil has two types of omega-6-fatty acid including linoleic acid (60%-80%) and γ-linoleic acid (8%-14%). Essential fatty acids are considered as essential compounds for body health, especially among women. The aim of this study was to evaluate the efficacy of evening primrose oil in the management of women ailments. The document was prepared by investigation in scientific articles of electronic resources (Google Scholar, PubMed, Science Direct, Wiley, Scopus, and Springer) by keywords of evening primrose oil and women. The results of our investigations showed that evening primrose oil has been the subject of several clinical studies, including premenstrual syndrome (PMS), hot flash, mastalgia, fibroadenomas, gestational diabetes, cervical ripening, and dilation. The major clinical studies are focused on mastalgia, followed by PMS. The results of studies confirmed the evening primrose oil's efficacy in women health, but the immediate response should not be expected from it, therefore, it should be regularly used up to 4 or 6 months.
PubMed: 31497576
DOI: 10.6118/jmm.18190 -
Acta Clinica Croatica Dec 2018- The aim of the study was to assess the role of the estradiol and progesterone relationship during the late luteal phase and the occurrence of fibrocystic breast...
- The aim of the study was to assess the role of the estradiol and progesterone relationship during the late luteal phase and the occurrence of fibrocystic breast disease (FBD). The concentration of estradiol/progesterone was measured in the group of women with FBD as study group (n=50) and control group of women without FBD (n=40). All women had regular ovulation cycles. Blood samples for estradiol (E2), progesterone (P) and prolactin determination were obtained in the morning at 8 am on days 21 and 24 of menstrual cycle. Significant mastalgia and mastodynia history in women with FBD was obtained with yes or no questionnaire. FBD diagnosis was confirmed with ultrasound (size and number of simple cysts). In the control group, a reduced E2/P ratio was noticed from day 21 to day 24 of the cycle (from 14.8±11.5 pg/mL to 9.1±6.1 pg/mL; p<0.05), which was not recorded in the group of women with FBD (study group). Even the slightest disturbance of the E2/P ratio may contribute to the occurrence of FBD with clinical manifestations of mastalgia and mastodynia.
Topics: Adult; Correlation of Data; Estradiol; Female; Fibrocystic Breast Disease; Humans; Luteal Phase; Mastodynia; Pain Measurement; Progesterone; Prolactin; Ultrasonography, Mammary
PubMed: 31168213
DOI: 10.20471/acc.2018.57.04.18 -
Acta Medica Portuguesa Feb 2019
Topics: Calciphylaxis; Fatal Outcome; Female; Humans; Kidney Failure, Chronic; Mastodynia; Middle Aged
PubMed: 30753809
DOI: 10.20344/amp.10495