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The British Journal of Radiology Oct 2020As tomosynthesis is rapidly adopted by breast imaging practices, tomosynthesis-guided procedures are increasingly being performed. Tomosynthesis-guided needle... (Review)
Review
As tomosynthesis is rapidly adopted by breast imaging practices, tomosynthesis-guided procedures are increasingly being performed. Tomosynthesis-guided needle localizations are feasible and efficient and allow for localization of tomosynthesis-only findings or one-view findings, which may be difficult to localize under standard digital mammography. In this review, we describe our step-by-step approach for performing tomosynthesis-guided localizations of the breast and axilla using a standard tomosynthesis unit.
Topics: Axilla; Breast Neoplasms; Female; Humans; Image-Guided Biopsy; Mammography; Radiographic Image Enhancement
PubMed: 32667855
DOI: 10.1259/bjr.20200495 -
Indian Pediatrics Jun 2013A rapidly growing soft tissue mass in the axilla of an infant raises the suspicion of a lipoblastoma or a liposarcoma. Excisional/incisional biopsy is vital in...
A rapidly growing soft tissue mass in the axilla of an infant raises the suspicion of a lipoblastoma or a liposarcoma. Excisional/incisional biopsy is vital in confirming the diagnosis and hence avoiding aggressive extirpation. This case report highlights the role of histopathology and immunohistochemistry as the gold standard in differentiating a lipoblastoma from a liposarcoma. In some cases where the histopathology is inconclusive, genetic rearrangement of the PLAG1 (pleomorphic adenoma gene 1) oncogene on chromosome 8q12 helps in confirming the diagnosis of lipoblastoma.
Topics: Axilla; Diagnosis, Differential; Female; Humans; Infant; Lipoblastoma; Liposarcoma, Myxoid
PubMed: 23942405
DOI: No ID Found -
Heart and Vessels Oct 2022The left axillary artery is an attractive alternative access route for transcatheter aortic valve replacement (TAVR) and may provide better outcomes compared to other...
The left axillary artery is an attractive alternative access route for transcatheter aortic valve replacement (TAVR) and may provide better outcomes compared to other alternatives. Nevertheless, there remain concerns about vascular complications, lack of compressibility, and thorax-related complications. Between March 2019 and March 2021, 13 patients underwent transaxillary TAVR for severe aortic stenosis at the University Hospital Bonn. The puncture was performed with a puncture at the distal segment of the axillary artery through the axilla, with additional femoral access for applying a safety wire inside the axillary artery. Device success was defined according to the VARC 2 criteria. The study participants were advanced in age (77 ± 9 years old), and 54% were female, with an intermediate risk for surgery (STS risk score 4.7 ± 2.0%). The average diameter of the distal segment of the axillary artery was 5.8 ± 1.0 mm (i.e., the puncture site) and 7.6 ± 0.9 mm for the proximal axillary artery. Device success was achieved in all patients. 30-day major adverse cardiac and cerebrovascular events were 0%. With complete percutaneous management, stent-graft implantation was performed at the puncture site in 38.5% of patients. Minor bleeding was successfully managed with manual compression. Moreover, no thorax-related complications, hematomas, or nerve injuries were observed. Percutaneous trans-axilla TAVR was found to be feasible and safe. This modified approach may mitigate the risk of bleeding and serious complications in the thorax and be less invasive than surgical alternatives.
Topics: Aged; Aged, 80 and over; Aortic Valve; Aortic Valve Stenosis; Axilla; Female; Femoral Artery; Hemorrhage; Humans; Male; Risk Factors; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 35505257
DOI: 10.1007/s00380-022-02082-3 -
Actas Dermo-sifiliograficas Jun 2007Granular parakeratosis is a rare entity that results from an acquired disorder of keratinization. Clinically presents as dark erythematous plaques, occasionally...
Granular parakeratosis is a rare entity that results from an acquired disorder of keratinization. Clinically presents as dark erythematous plaques, occasionally pruritic, that usually involve the axilla and other intertriginous areas. The pathology is characteristic and consists of thickening of the stratum corneum with compact parakeratosis and retention of keratohyaline granules, whereas the stratum granulosum is preserved. The etiology is unknown although some factors such as irritating physical or chemical agents have been implicated. Treatment response is variable. We report a new case in a 50-year-old woman with brownish and hyperkeratotic plaques on both axillae, of two years duration, with a compatible pathology that showed a favorable response to tacalcitol.
Topics: Axilla; Female; Humans; Middle Aged; Parakeratosis
PubMed: 17555680
DOI: 10.1016/s0001-7310(07)70081-9 -
British Medical Journal Jan 1970
Topics: Adult; Axilla; Humans; Iodine; Male; Starch; Sweat Glands; Sweating
PubMed: 5411606
DOI: 10.1136/bmj.1.5687.48-a -
Revista Da Associacao Medica Brasileira... 2015The authors discuss the main innovations in the diagnosis and treatment of breast cancer, particularly in diagnostic imaging and screening, and in locoregional and... (Review)
Review
The authors discuss the main innovations in the diagnosis and treatment of breast cancer, particularly in diagnostic imaging and screening, and in locoregional and systemic therapies.
Topics: Axilla; Breast Neoplasms; Drug Therapy; Female; Humans; Lymph Node Excision; Lymph Nodes; Mammography; Mastectomy; Sensitivity and Specificity
PubMed: 26841165
DOI: 10.1590/1806-9282.61.06.543 -
Current Treatment Options in Oncology May 2020As the use of neoadjuvant systemic therapy (NAST) increases, the optimal management of the axilla has become increasingly complex. Consensus among professional... (Review)
Review
As the use of neoadjuvant systemic therapy (NAST) increases, the optimal management of the axilla has become increasingly complex. Consensus among professional organizations is that those patients with clinically negative axillary nodes who are being considered for NAST should undergo a sentinel lymph node (SLN) biopsy following NAST. If a positive SLN is subsequently identified, an axillary lymph node dissection (ALND) is the current standard of care. For patients with clinically node-positive disease, SLN biopsy is a reasonable option for those with a good response to NAST. Patients should undergo SLN mapping with a dual dye technique. Additionally, at least 2 lymph nodes should be removed, including the previously biopsied and marked lymph node with cancer. In this setting, the identification and false negative rates are acceptable. Patients found to have a negative SLN at this time may be spared the morbidity associated with ALND. Patients found to have persistently positive lymph nodes following NAST, either clinically or pathologically, should undergo a complete ALND.
Topics: Axilla; Breast Neoplasms; Clinical Decision-Making; Clinical Trials as Topic; Disease Management; Female; Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Neoadjuvant Therapy; Sentinel Lymph Node Biopsy; Treatment Outcome
PubMed: 32462230
DOI: 10.1007/s11864-020-00755-7 -
Wounds : a Compendium of Clinical... Feb 2022Hidradenitis suppurativa can be a debilitating condition, particularly in the pediatric population. Axillary hidradenitis can be particularly challenging because of the...
INTRODUCTION
Hidradenitis suppurativa can be a debilitating condition, particularly in the pediatric population. Axillary hidradenitis can be particularly challenging because of the risk of scar contracture and limited range of motion after definitive resection and reconstruction. A dermal regeneration template (DRT) and skin grafting have been used to reduce scar contracture in other areas of the body and may benefit this population.
OBJECTIVE
This case series retrospectively reviewed and evaluated outcomes using DRT and skin grafting for axillary hidradenitis reconstruction to report the authors' initial experience.
MATERIALS AND METHODS
After institutional review board approval, a retrospective review was conducted of a single surgeon's experience for all patients undergoing axillary hidradenitis resection and immediate reconstruction with DRT and skin grafting from 2015 through 2018. Preoperative characteristics, surgical details, and postoperative results were collected.
RESULTS
Five patients undergoing 7 procedures were eligible for inclusion. The average age at the time of surgery was 18.2 years. Patients underwent an average of 4.9 negative pressure wound therapy changes prior to skin grafting. No complications, DRT loss, or skin graft loss occurred. All patients were reported to have normal range of motion of the surgically managed extremity after skin grafting. The average follow-up was 273.4 days after the last procedure. As of this writing, no patients had experienced any recurrence of hidradenitis in the surgically managed axilla.
CONCLUSIONS
The use of DRT and subsequent skin grafting for the definitive management of axillary hidradenitis resulted in no recurrence and full range of motion of the affected extremity without complications. Surgeons should consider using this method of reconstruction for axillary hidradenitis, particularly in the pediatric population.
Topics: Axilla; Child; Cicatrix; Contracture; Hidradenitis Suppurativa; Humans; Plastic Surgery Procedures; Retrospective Studies; Skin Transplantation
PubMed: 35801979
DOI: 10.25270/wnds/110121.01 -
Acta Dermatovenerologica Alpina,... Dec 2018Many dermatologic conditions affect the axillae; however, identification is often difficult due to similar clinical presentations. The axillae are unique due to their... (Review)
Review
Many dermatologic conditions affect the axillae; however, identification is often difficult due to similar clinical presentations. The axillae are unique due to their increased humidity, as well as their high density of hair follicles and sweat glands. Furthermore, they are a site of increased friction due to the presence of closely opposing skin surfaces. In addition to the axillae being involved with common skin diseases affecting other body surface areas, these unique factors also predispose the axillae to less common skin manifestations. This review categorizes the various conditions based on their inflammatory or infectious etiology and describes each condition based on their predominant characteristics, such as lesion type and color, methods of diagnosis, and treatment. Overall, the goal of this review is to provide a broad differential of conditions affecting the axillae so that conditions can be differentiated from one another and treated effectively.
Topics: Axilla; Humans; Skin Diseases
PubMed: 30564831
DOI: No ID Found -
Clinical Medicine (London, England) Feb 2016Hidradenitis suppurativa (HS) is a chronic, painful skin disease characterised by recurrent inflammatory lesions in flexural locations such as the axillae, groins and...
Hidradenitis suppurativa (HS) is a chronic, painful skin disease characterised by recurrent inflammatory lesions in flexural locations such as the axillae, groins and perineum. The papules, nodules and abscesses may discharge blood-stained pus which, combined with pain, results in marked quality-of-life reduction. Sinus tracts and scarring may also result. Onset of HS is typically in the second to fourth decades and it affects about 1% of young European adults. There are links with smoking and obesity and an autosomal dominant pattern of inheritance is reported by one-third of patients. Medical management escalates from topical antimicrobials to oral tetracyclines, a combination of clindamycin and rifampicin typically given for 10 weeks, oral disease modifiers, and anti-tumour necrosis factor-alpha therapies. Excision of individual lesions has high recurrence rates which can be minimised by wider excisions, at the expense of longer healing times. Treatment of pain is a relatively neglected aspect of therapy.
Topics: Adult; Axilla; Female; Hidradenitis Suppurativa; Humans; Male; Obesity; Pain Management; Quality of Life; Risk Factors; Skin; Smoking
PubMed: 26833521
DOI: 10.7861/clinmedicine.16-1-70