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Annals of the Royal College of Surgeons... Jul 2024Total duct excision (TDE) is performed for the diagnosis and management of nipple discharge. The Association of Breast Surgery's recent guidelines recommend considering...
INTRODUCTION
Total duct excision (TDE) is performed for the diagnosis and management of nipple discharge. The Association of Breast Surgery's recent guidelines recommend considering diagnostic surgery for single-duct, blood-stained or clear nipple discharge, and for symptomatic management.
METHODS
We retrospectively reviewed the diagnostic and surgical outcomes of all cases of TDE between January 2013 and November 2019.
RESULTS
In total, 259 TDEs were carried out: 219 for nipple discharge, 29 for recurrent mastitis, 3 for screening abnormalities and 8 for breast lumps. Of the nipple discharge group, 121 had blood-stained discharge. Mean patient age was 52 years (range 19-81). Median follow-up time was 45 months (interquartile range 24-63). The following cases were identified on histopathology: 236 benign breast changes, 10 atypical ductal hyperplasia, 4 lobular carcinoma in situ, 2 low-grade ductal carcinoma in situ (DCIS), 3 intermediate-grade DCIS, 2 high-grade DCIS and 2 invasive ductal carcinomas. In total, 3.5% of patients who underwent TDE had a diagnosis of DCIS or invasive carcinoma. Blood-stained discharge was associated with a significant increase in risk of DCIS or carcinoma compared with other nipple discharge colours ( = 0.043). The most common complications of TDE were infection, poor wound healing and haematoma. Nipple discharge recurred in 14.2% of cases.
CONCLUSIONS
TDE can be considered for the diagnostics and management of nipple discharge. Blood-stained nipple discharge increases the risk of DCIS or malignancy, but the majority of the time TDE reveals benign breast pathology.
Topics: Humans; Female; Middle Aged; Adult; Retrospective Studies; Aged; Nipple Discharge; Aged, 80 and over; Breast Neoplasms; Young Adult; Nipples; Treatment Outcome; Carcinoma, Intraductal, Noninfiltrating; Mammary Glands, Human
PubMed: 38497796
DOI: 10.1308/rcsann.2022.0093 -
Enfermeria Clinica (English Edition) 2024To evaluate the degree of satisfaction of women treated with dermopigmentation and reconstruction of the Areola-Nipple Complex (ANC) after breast reconstruction, as well... (Observational Study)
Observational Study
OBJECTIVE
To evaluate the degree of satisfaction of women treated with dermopigmentation and reconstruction of the Areola-Nipple Complex (ANC) after breast reconstruction, as well as their demographic profile and clinical-evolutionary characteristics.
METHODS
Descriptive observational study including 128 women treated with dermopigmentation after oncologic breast reconstruction during 2018. In 2021 they were administered an adapted satisfaction questionnaire, which contains 27 items and categorizes satisfaction from 1-5, in addition other clinical-evolutionary and demographic variables were collected.
RESULTS
Mean age was 51 (±9) years, 89.1% had previously undergone PDA reconstruction. Mean satisfaction with dermopigmentation was 4.4 (±0.88) and 3.79 (±1.06) for PDA reconstruction. Complications were rare, but 54.5% (n = 54) of the patients reported that the CAP reconstruction did not offer the expected projection, 91.6% (n = 98) that the color had faded and 51.4% (n = 55) would choose permanent tattooing. It was perceived that, the higher the satisfaction of the CAP, the higher the satisfaction of dermopigmentation, while the older the age and previous chemotherapy treatment the lower the color durability (p value ≤ 0.05).
CONCLUSIONS
Patients who underwent reconstructive breast surgery show a high degree of satisfaction with dermopigmentation and surgical reconstruction of the PDA, but reiterate the low projecticity of the dermopigmentation and the surgical reconstruction of the PDA, but reiterate the low degree of satisfaction with the dermopigmentation.
Topics: Humans; Female; Middle Aged; Mammaplasty; Patient Satisfaction; Nipples; Breast Neoplasms; Adult; Tattooing; Aged; Skin Pigmentation
PubMed: 38484934
DOI: 10.1016/j.enfcle.2024.03.002 -
Photodiagnosis and Photodynamic Therapy Apr 2024Photodynamic therapy (PDT) is a non-invasive, effective treatment for superficial skin conditions, offering superior cosmetic outcomes compared with traditional...
Photodynamic therapy (PDT) is a non-invasive, effective treatment for superficial skin conditions, offering superior cosmetic outcomes compared with traditional therapies. Bowen's disease (BD) of the nipple-areola complex (NAC) is rare and thus, lacks a standardized treatment approach. This report details the case of a 48-year-old woman who was successfully treated for BD of the NAC using PDT. Over a follow-up period of 30 months, there was no evidence of disease recurrence, underscoring the potential of PDT as a viable treatment option for this rare manifestation of BD.
Topics: Humans; Female; Photochemotherapy; Middle Aged; Bowen's Disease; Nipples; Photosensitizing Agents; Cryotherapy; Skin Neoplasms; Combined Modality Therapy; Breast Neoplasms; Aminolevulinic Acid
PubMed: 38460656
DOI: 10.1016/j.pdpdt.2024.104041 -
Gland Surgery Feb 2024Granulomatous lobular mastitis (GLM) is a chronic inflammatory breast condition characterized by an unclear etiology and an undefined therapeutic approach. Surgical...
BACKGROUND
Granulomatous lobular mastitis (GLM) is a chronic inflammatory breast condition characterized by an unclear etiology and an undefined therapeutic approach. Surgical intervention is considered an alternative modality for managing GLM. Staged operation is the predominant and characteristic surgical approach in the treatment of GLM in our center; therefore, we evaluated the efficacy of staged operative techniques in this cohort study.
METHODS
We retrospectively reviewed 212 patients with GLM who underwent staged operation between August 2020 and July 2022 in the inpatient department of our institute. Their clinical history information, clinic complaints, treatment details, surgical outcomes, follow-up results, and scores on the satisfaction questionnaire were analyzed. The patients were called for follow-up and consultation with a deadline of August 2023.
RESULTS
The median follow-up time was 27 months (range, 14-37 months). In total, 212 patients were treated with three different staged procedures according to the individual assessment and patient willingness, including 168 patients who underwent one-stage debridement operation and two-stage suture operation (DO + SO), 25 patients who underwent one-stage debridement operation without suture (DO), and 19 patients who underwent one-stage debridement and simultaneous suture operation (DSO). The median recovery time was 29 days (range, 14-60 days). A minority of patients developed postoperative complications, including effusion (1.89%), flap ischemia (0.94%), areola-nipple ischemia (0.94%) and sinus tract formation (2.36%). The scores of the satisfaction questionnaire were 43.10±3.09, and 186 patients (87.74%) gave high scores for postoperative breast appearance. Only 5 of 212 patients (2.36%) developed recurrence.
CONCLUSIONS
Staged operation performed in our institute is an effective and safe surgical therapy in patients with GLM, yielding a short recovery time, low recurrence and good cosmetic results.
PubMed: 38455353
DOI: 10.21037/gs-23-386 -
Biomedicine & Pharmacotherapy =... Apr 2024Gynura procumbens (Lour.) Merr., utilized in traditional Chinese medicine, is known for its liver-protective, liver-soothing, and depression-alleviating properties. This...
Gynura procumbens (Lour.) Merr., utilized in traditional Chinese medicine, is known for its liver-protective, liver-soothing, and depression-alleviating properties. This research examines the antidepressant and anti-hyperprolactinemia potentials of an ethanol extract from G. procumbens stems (EEGS) and specific metabolites. To model depression and hyperprolactinemia, chronic unpredictable mild stress (CUMS) was induced in mice and risperidone was administered to rats, respectively. Treatments involved administering low (5 mg/kg), medium (25 mg/kg), and high (125 mg/kg) doses of EEGS and certain metabolites to both models. Behavioral assessments were conducted in the CUMS-induced mice, while the CA3 neuronal damage in mice and histopathological alterations in rat mammary glands were evaluated using Nissl and Hematoxylin & Eosin staining techniques, respectively. EEGS decreased immobility times in the forced swimming and tail suspension tests in mice, enhancing their exploration of the central zone. It elevated the serum levels of 5-hydroxytryptamine, norepinephrine, estradiol, luteinizing hormone (LH), and testosterone in mice. Moreover, EEGS restored the neuronal cell arrangement in the CA3 area, reduced interleukin-1beta mRNA production, and increased the expression of interleukin-10 and beta-catenin mRNA. In the context of risperidone-induced hyperprolactinemia, EEGS lowered blood prolactin levels, reduced the dimensions of rat nipples, and enhanced LH, progesterone, and dopamine levels, alongside mitigating mammary hyperplasia. Among the EEGS selected metabolites, the combined effect of chlorogenic acid and trans-p-coumaric acid was found to be more effective than the action of each compound in isolation. Collectively, the findings indicate that EEGS and its selected metabolites offer promising antidepressant benefits while counteracting hyperprolactinemia.
Topics: Rats; Mice; Animals; Hyperprolactinemia; Risperidone; Plant Extracts; Asteraceae; Antidepressive Agents; RNA, Messenger; Depression; Disease Models, Animal; Stress, Psychological
PubMed: 38428310
DOI: 10.1016/j.biopha.2024.116361 -
Indian Journal of Pathology &... Apr 2024Syringoid eccrine carcinoma of nipple is an extremely rare neoplasm of adnexal origin with variable clinical appearance and diverse histologic findings. Syringoid...
Syringoid eccrine carcinoma of nipple is an extremely rare neoplasm of adnexal origin with variable clinical appearance and diverse histologic findings. Syringoid eccrine carcinoma (SEC) is often a diagnostic dilemma due to its morphology and presentation. Usually, these malignancies arise as non-ulcerated nodules or plaques in the head & neck region including the trunk. They are locally aggressive and have an infiltrative growth pattern with a propensity for metastasis. SEC is characterized by syringoma-like tadpole morphology with ductular differentiation and predominant desmoplasia. Immunostaining in SEC is variable and this variability is believed to arise from the tumor's ability to differentiate along multiple routes including sweat secretory and or ductal differentiation. Here we present a rare case of SEC/ syringomatous carcinoma of nipple in a 51-year-old male breast with associated axillary lymph node metastasis. As per English literature, this is the second case of SEC in nipple of male patient.
Topics: Humans; Male; Middle Aged; Nipples; Lymphatic Metastasis; Sweat Gland Neoplasms; Breast Neoplasms, Male; Lymph Nodes; Immunohistochemistry; Eccrine Glands; Biomarkers, Tumor; Axilla; Carcinoma
PubMed: 38427763
DOI: 10.4103/ijpm.ijpm_716_23 -
Awareness and practice of breast self-examination among female staff at Babcock University, Nigeria.Ecancermedicalscience 2023Despite the ever-growing breast cancer awareness campaigns in Nigeria, the practice of breast self-examination (BSE) continues to vary widely among women. We aimed to...
BACKGROUND
Despite the ever-growing breast cancer awareness campaigns in Nigeria, the practice of breast self-examination (BSE) continues to vary widely among women. We aimed to assess breast cancer awareness and practice of BSE among female staff at Babcock University, Ogun State, Nigeria.
METHODS
The cross-sectional descriptive design was adopted for this study. Data were collected using a structured questionnaire administered to 160 respondents. Data analysis was done using Statistical Package for Social Sciences version 23.
RESULTS
Although the majority of the respondents were highly aware of breast cancer (78.12%) and had good knowledge about BSE (96.9%), their practice of BSE was low. Only 11.3% always examine their breasts in the mirror by raising their hands over their head, looking at their breasts and examining it in a circular motion; 56% rarely looked for puckering, colour changes and dimpling of the skin when examining their breasts in the mirror, although 53.8% sometimes squeezed their nipples and looked for discharge when they examined their breasts.
CONCLUSION
Knowledge and positive opinions toward preventive strategies for breast cancer should not be interpreted as readiness for practice. Educational intervention programs emphasising the importance of early detection in managing breast cancer should be reinforced to birth the desirable change.
PubMed: 38414968
DOI: 10.3332/ecancer.2023.1615 -
European Journal of Surgical Oncology :... Apr 2024In the developmental stage of minimal-accessed nipple-sparing mastectomy (MA-NSM), selecting patients with small to medium-sized breasts was common for better cosmetic...
BACKGROUND
In the developmental stage of minimal-accessed nipple-sparing mastectomy (MA-NSM), selecting patients with small to medium-sized breasts was common for better cosmetic outcomes and oncological safety. However, the suitability of MA-NSM for large, ptotic breasts remained uncertain. This retrospective study aim to assess MA-NSM outcomes in patients with large breasts.
MATERIALS AND METHODS
This retrospective study included patients receiving conventional NSM (C-NSM) and MA-NSM from January 2011 to September 2022, at a single institution. We analyzed perioperative parameters and clinical outcomes based on breast specimen size, classified as small (≤300 g), medium (>300-450 g), large (>450-600 g), and very large (>600 g).
RESULTS
A total of 728 patients was enrolled. C-NSM was performed in 51% (371/728) of cases, while MA-NSM was done in 49% (357/728). The overall complication rate of MA-NSM was comparable to C-NSM (p = 0.573), but severe complications (Clavien-Dindo, CD III) was significantly reported more following C-NSM, regardless of breast size. During a median follow-up of 52 months, no significant difference in oncological outcomes was observed. Comparing MA-NSM and C-NSM outcomes in large-very large breasts (>450 g), MA-NSM demonstrated significantly less blood loss (p = 0.036) and lower incidence of severe complications (CD ≥ III) compared to C-NSM (p = 0.002).
CONCLUSION
MA-NSM is feasible for large breasts and offers benefits by reducing blood loss and decreasing the incidence of severe complications (CD ≥ III) in this patient group.
Topics: Humans; Female; Mastectomy; Mammaplasty; Retrospective Studies; Nipples; Robotic Surgical Procedures; Breast Neoplasms
PubMed: 38402736
DOI: 10.1016/j.ejso.2024.108030 -
Fine structure of the compound eyes of the crepuscular moth (Busck 1916) (Lepidoptera: Tortricidae).Frontiers in Physiology 2024Morphological organization, ultrastructure and adaptational changes under different light intensities (10000, 100, 1, and 0.01 mW/m) of the compound eye of the oriental...
Morphological organization, ultrastructure and adaptational changes under different light intensities (10000, 100, 1, and 0.01 mW/m) of the compound eye of the oriental fruit moth (Busck 1916) were investigated. Its superposition type of eyes consist of approximately 1072 ommatidia in males and 1029 ommatidia in females with ommatidial diameters of around 15 μm. Each ommatidium features a laminated corneal lens densely covered by corneal nipples of 256 nm in height. Crystalline cones are formed by four cone cells, proximally tapering to form a narrow crystalline tract with a diameter of 1.5 μm. Eight retinula cells, two primary and six secondary pigment cells per ommatidium are present. The 62.3 μm long rhabdom is divided into a thin 1.8 μm wide distal and a 5.2 μm wide proximal region. Distally the fused rhabdom consists of the rhabdomeres of seven retinula cells (R1-R7) and connects with the crystalline cone. In the proximal rhabdom region, the pigment-containing retinula cell R8 occupies a position in centre of the rhabdom while R1-R7 cells have taken peripheral positions. At this level each ommatidial group of retinula cells is surrounded by a tracheal tapetum. In response to changes from bright-light to dim-light adaptations, the pigment granules in the secondary pigment cells and retinula cells migrate distally, with a decrease in the length of crystalline tract.
PubMed: 38390450
DOI: 10.3389/fphys.2024.1343702 -
The Breast Journal 2024Mammoplasty is a surgery commonly used for macromastia. Many mammoplasty techniques are described, all with their specific pros and cons. However, the concern to avoid...
Mammoplasty is a surgery commonly used for macromastia. Many mammoplasty techniques are described, all with their specific pros and cons. However, the concern to avoid serious complications sometimes takes precedence, and the ideal result cannot be. For macromastia and severely ptotic breasts, usually the free nipple-areolar complex (NAC) mammoplasty technique is implemented. The results, however, may only be completely satisfactory regarding cosmetics. Loss of NAC, poor appearance, flabbiness, flattening, and ptosis are among the disadvantages of this technique. This study aimed to present the results of mammoplasty employing the superomedial pedicle technique without interrupting a macromastia central base with a pedicle length of 8 to 18 cm. According to the literature, many plastic surgeons recommend the free NAC rather than the pedicle technique because of the high complication rates in mammoplasties planned for highly ptotic breasts and macromastia. On the other hand, many free NAC techniques and their modifications with pedicle mammoplasty are described. The general conviction is that a standard method, protocol, or technique good for all patients does not exist. Our results are more acceptable both cosmetically and physiologically. Therefore, the superomedial pedicle technique can be modified to achieve ideal results where free NAC mammoplasty is considered for severe macromastia and ptotic patients. This combined method contributes to the viability of NAC by increasing blood supply to breast tissue and providing an ideal breast appearance.
Topics: Humans; Female; Treatment Outcome; Breast Neoplasms; Breast; Mammaplasty; Nipples; Retrospective Studies; Hypertrophy
PubMed: 38389976
DOI: 10.1155/2024/7635485