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BMJ Case Reports Apr 2019Male breast cancer is a rare but important condition accounting for only 1% of breast cancer worldwide and less than 1% of all male malignancies. Occult male breast...
Male breast cancer is a rare but important condition accounting for only 1% of breast cancer worldwide and less than 1% of all male malignancies. Occult male breast cancer is an extremely rare type of male breast cancer that manifests as axillary metastases without an identifiable breast lesion. We report a case of triple-negative occult male breast cancer who underwent modified radical mastectomy.
Topics: Aged, 80 and over; Axilla; Breast Neoplasms, Male; Carcinoma, Ductal, Breast; Humans; Lymph Nodes; Magnetic Resonance Imaging; Male; Mastectomy, Modified Radical; Neoplasms, Second Primary; Triple Negative Breast Neoplasms
PubMed: 31005873
DOI: 10.1136/bcr-2019-229482 -
The Pan African Medical Journal 2020Accessory breast tissue is an uncommon condition which occurs in 0.4-6% of women. It is mostly located in the axilla and has a high incidence of being misdiagnosed....
Accessory breast tissue is an uncommon condition which occurs in 0.4-6% of women. It is mostly located in the axilla and has a high incidence of being misdiagnosed. Usually it is bilateral and presents as an asymptomatic mass during pregnancy or lactation. The diagnosis of ectopic breast tissue is important as it can undergo the same pathological changes that occur in a normal breast, such as mastitis, fibrocystic disease and carcinoma. We present a case of a bilateral axillary localization of accessory breast in a 45-year-old woman. The principal symptom was pain and the clinical diagnosis was bilateral lipoma. However, subsequent imaging and histopathological examination proved it to be an accessory breast tissue.
Topics: Axilla; Breast; Breast Diseases; Diagnosis, Differential; Female; Humans; Middle Aged
PubMed: 33117476
DOI: 10.11604/pamj.2020.36.282.20445 -
Radiographics : a Review Publication of... 2022Axillary lymphadenopathy caused by the high immunogenicity of messenger RNA (mRNA) COVID-19 vaccines presents radiologists with new diagnostic dilemmas in...
Axillary lymphadenopathy caused by the high immunogenicity of messenger RNA (mRNA) COVID-19 vaccines presents radiologists with new diagnostic dilemmas in differentiating vaccine-related benign reactive lymphadenopathy from that due to malignant causes. Understanding axillary anatomy and lymphatic drainage is key to radiologic evaluation of the axilla. US plays a critical role in evaluation and classification of axillary lymph nodes on the basis of their cortical and hilar morphology, which allows prediction of metastatic disease. Guidelines for evaluation and management of axillary lymphadenopathy continue to evolve as radiologists gain more experience with axillary lymphadenopathy related to COVID-19 vaccines. General guidelines recommend documenting vaccination dates and laterality and administering all vaccine doses contralateral to the site of primary malignancy whenever applicable. Guidelines also recommend against postponing imaging for urgent clinical indications or for treatment planning in patients with newly diagnosed breast cancer. Although conservative management approaches to axillary lymphadenopathy initially recommended universal short-interval imaging follow-up, updates to those approaches as well as risk-stratified approaches recommend interpreting lymphadenopathy in the context of both vaccination timing and the patient's overall risk of metastatic disease. Patients with active breast cancer in the pretreatment or peritreatment phase should be evaluated with standard imaging protocols regardless of vaccination status. Tissue sampling and multidisciplinary discussion remain useful in management of complex cases, including increasing lymphadenopathy at follow-up imaging, MRI evaluation of extent of disease, response to neoadjuvant treatment, and potentially confounding cases. RSNA, 2022.
Topics: Humans; Female; Lymphatic Metastasis; COVID-19; COVID-19 Vaccines; Axilla; Lymph Nodes; Breast Neoplasms; Lymphadenopathy; Magnetic Resonance Imaging; Radiologists
PubMed: 36018786
DOI: 10.1148/rg.220045 -
Anaesthesiology Intensive Therapy 2015Axillary brachial plexus block is one of the most frequently employed peripheral blocks. The popularity of axillary block stems from its success as a safe and relatively... (Review)
Review
Axillary brachial plexus block is one of the most frequently employed peripheral blocks. The popularity of axillary block stems from its success as a safe and relatively easy technique with numerous applications. The technique of axillary block has evolved. It was modified after the development of precise nerve localization modalities. Currently, ultrasound is the most important localization technique for regional anaesthesia. Ultrasound-guided axillary block encompasses a spectrum of techniques. The selection of a specific technique can be adjusted to an operator's individual level of skill and proficiency. Axillary block under US-guidance can be performed using a traditional perivascular method and by placing a selective blockade of individual nerves that supply the surgical area. Regardless of the selected method, it enables the incorporation of individual patient anatomical variation in an anaesthesia plan. This paper discusses the technical details and efficacy issues of US-guided axillary brachial plexus block techniques.
Topics: Axilla; Brachial Plexus; Humans; Nerve Block; Safety; Ultrasonography, Interventional
PubMed: 26401747
DOI: 10.5603/AIT.2015.0053 -
Medicine Nov 2018Lymphangiomas develop in the head, neck, and axilla of patients <2 years old in more than 90% of cases. They are rarely reported in adults. (Review)
Review
RATIONALE
Lymphangiomas develop in the head, neck, and axilla of patients <2 years old in more than 90% of cases. They are rarely reported in adults.
PATIENT CONCERNS
Here, we report on a 37-year-old woman with a firm, hypoechoic 3.3 cm mass in the right upper, outer quadrant of the breast with discomfort, and swelling of the right axillary region.
DIAGNOSIS AND INTERVENTIONS
She underwent wide excision of the right breast and axillary lesion and the lesion pathologic finding is lymphangioma of the breast.
OUTCOMES
She was in good condition with no signs of postoperative complications and no evidence of recurrence at 6 months postsurgery.
LESSONS
Despite the rarity of breast cystic lymphangioma, its evaluation should be considered for prompt diagnosis and definitive treatment to prevent recurrence and complications. Furthermore, this is the first case of concomitant lymphangioma of the breast parenchyma and axillary region.
Topics: Adult; Axilla; Breast Neoplasms; Female; Humans; Lymphangioma, Cystic
PubMed: 30407286
DOI: 10.1097/MD.0000000000012946 -
Archives of Physical Medicine and... Sep 2022To determine the cumulative incidence and natural history of axillary web syndrome (AWS) and its related postoperative risk for physical impairments in a cohort of women...
Five-Year Cumulative Incidence of Axillary Web Syndrome and Comparison in Upper Extremity Movement, Function, Pain, and Lymphedema in Survivors of Breast Cancer With and Without Axillary Web Syndrome.
OBJECTIVE
To determine the cumulative incidence and natural history of axillary web syndrome (AWS) and its related postoperative risk for physical impairments in a cohort of women followed for 5 years post breast cancer surgery.
DESIGN
Prospective, longitudinal study.
SETTING
Academic health center.
PARTICIPANTS
Women (N=36) with and without AWS after breast cancer surgery with sentinel node biopsy or axillary lymph node dissection.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Participants were assessed for AWS, shoulder goniometric flexion and abduction range of motion, function (Disability of the Arm, Shoulder, and Hand), lymphedema (bioimpedance spectroscopy, girth measures, tissue dielectric constant), and pain (visual analog scale) at 2, 4, 12, and 78 weeks and 5 years after breast cancer surgery. Analysis of variance compared range of motion, function, lymphedema, and pain in women identified with AWS with those without AWS across visits. Univariate logistic regression assessed if AWS was a risk factor for physical impairment at 5 years.
RESULTS
The cumulative incidence of AWS was 57%. Fifty percent (14/28) of the women who completed all study visits had signs of AWS at 5 years. Abduction active range of motion was significantly lower in women with AWS at 2 and 4 weeks post surgery. AWS was identified as a risk factor for reduced shoulder motion at 5 years. Regardless of AWS, 75% of the women experienced 1 or more upper extremity physical impairments at 5 years, which is an increase from 66% at 78 weeks in the same cohort.
CONCLUSIONS
AWS is associated with reduced shoulder range of motion in the early postoperative time period, can persist for 5 years after breast cancer surgery, and increases the risk of long-term reduced shoulder range of motion. Long-term physical issues are apparent after breast cancer surgery regardless of AWS.
Topics: Axilla; Breast Neoplasms; Female; Humans; Incidence; Longitudinal Studies; Lymph Node Excision; Lymphedema; Pain; Prospective Studies; Range of Motion, Articular; Survivors; Upper Extremity
PubMed: 35398047
DOI: 10.1016/j.apmr.2022.03.007 -
European Annals of Otorhinolaryngology,... Jun 2015Robot-assisted transaxillary thyroid surgery avoids the need for a neck incision. It consists of thyroid lobectomy and isthmectomy for moderately large unilateral benign...
Robot-assisted transaxillary thyroid surgery avoids the need for a neck incision. It consists of thyroid lobectomy and isthmectomy for moderately large unilateral benign nodules. The surgical imperatives are the same as for conventional surgery, but with differences in terms of patient positioning, surgical incision, equipment, surgical technique and indications. The purpose of this article is to describe the equipment, patient positioning and surgical technique of exclusive robot-assisted transaxillary total thyroid lobectomy and isthmectomy.
Topics: Axilla; Feasibility Studies; Humans; Patient Satisfaction; Patient Selection; Robotics; Thyroid Diseases; Thyroid Neoplasms; Thyroidectomy; Treatment Outcome
PubMed: 25980627
DOI: 10.1016/j.anorl.2015.04.002 -
Journal of the American Veterinary... May 2014To compare rectal versus axillary temperatures in dogs and cats.
OBJECTIVE
To compare rectal versus axillary temperatures in dogs and cats.
DESIGN
Prospective observational study.
ANIMALS
94 dogs and 31 cats.
PROCEDURES
Paired axillary and rectal temperatures were measured in random order with a standardized method. Animal signalment, initial complaint, blood pressure, blood lactate concentration, and variables associated with vascular perfusion and coat were evaluated for associations with axillary and rectal temperatures.
RESULTS
Axillary temperature was positively correlated with rectal temperature (ρ = 0.75 in both species). Median axillary temperature (38.4°C [101.1°F] in dogs, and 38.4°C [101.2°F] in cats) was significantly different from median rectal temperature in dogs (38.9°C [102.0°F]) but not in cats (38.6°C [101.5°F]). Median rectal-axillary gradient (difference) was 0.4°C (0.7°F; range, -1.3° to 2.3°C [-2.4° to 4.1°F]) in dogs and 0.17°C (0.3°F; range -1.1° to 1.6°C [-1.9° to 3°F]) in cats. Sensitivity and specificity for detection of hyperthermia with axillary temperature were 57% and 100%, respectively, in dogs and 33% and 100%, respectively, in cats; sensitivity and specificity for detection of hypothermia were 86% and 87%, respectively, in dogs and 80% and 96%, respectively, in cats. Body weight (ρ = 0.514) and body condition score (ρ = 0.431) were correlated with rectal-axillary gradient in cats.
CONCLUSIONS AND CLINICAL RELEVANCE
Although axillary and rectal temperatures were correlated in dogs and cats, a large gradient was present between rectal temperature and axillary temperature, suggesting that axillary temperature should not be used as a substitute for rectal temperature.
Topics: Animals; Axilla; Body Temperature; Cats; Dogs; Rectum; Reference Values; Thermometers
PubMed: 24786164
DOI: 10.2460/javma.244.10.1170 -
Scientific Reports Jul 2023The purpose is to analyze and compare postoperative recovery and complication incidence between a periareolar incision combined with Suspension-type Mastoscopic Axillary... (Randomized Controlled Trial)
Randomized Controlled Trial
The purpose is to analyze and compare postoperative recovery and complication incidence between a periareolar incision combined with Suspension-type Mastoscopic Axillary Lymph Node Dissection (SMALND) and traditional inflated Mastoscopic Axillary Lymph Node Dissection (MALND). This was a randomized trial conducted from June 1, 2020, to April 30, 2022, in the Department of Second Breast Surgery, Shengjing Hospital of China Medical University, and the Department of Thyroid and Breast Surgery, Zibo Central Hospital, in accordance with the criteria of inclusion and exclusion. Overall, 126 patients diagnosed and treated for early-stage breast cancer were selected to undergo periareolar-incision breast-conserving surgery. Those patients who underwent periareolar-incision surgery combined with SMALND formed the observation group (SMALND Group), while those who underwent periareolar-incision surgery combined with traditional inflation became MALND Group. In the two groups, paired data "t" was used to examine, analyze, and compare the postoperative daily drainage volume and drain removal time, while paired data "χ" was used to examine, analyze, and compare the incidences of postoperative upper limb edema and paresthesia. There were 64 cases in the SMALND Group and 62 cases in the MALND Group. Between the two clusters, no differences were found in age, clinical staging, BMI, and breast cancer classification (P > 0.05). The intraoperative surgery time of the SMALND Group was 43.37 ± 6.27 min while that of the MALND Group was longer: 45.72 ± 4.25 min (P < 0.05). The intraoperative hemorrhage volume of the SMALND Group was 88.33 ± 16.79 ml, less than that of the MALND Group: 96.76 ± 26.85 ml (P < 0.05). The postoperative axillary mean daily drainage volume of the SMALND Group was 38.17 ± 5.55 ml, less than that of the MALND Group: 40.72 ± 7.25 ml (P < 0.05). The drain removal time of the SMALND Group was 7.50 ± 1.60, less than that of the MALND Group: 9.00 ± 1.80 (P < 0.05). The upper limb edema incidence rate of the SMALND Group was 3.12% (2/64) and had no obvious difference from the MALND Group, which was 4.83% (3/62) (P = 0.62). The paresthesia incidence rate of the SMALND Group was 18.75% (12/64), while that of the MALND Group was 17.7% (11/62), without an obvious difference (P = 0.88). For axillary lymph node dissection, the use of non-lipolytic suspension-type mastoscopy has reduced the intraoperative hemorrhage volume of patients, shortened surgery time and postoperative recovery time, saved treatment expenses for patients, and avoided complications such as hypercapnia and subcutaneous emphysema caused by traditional inflated mastoscopic surgery. Moreover, it has not increased the incidence of postoperative upper limb edema and paresthesia, supporting its safety and effectiveness.
Topics: Female; Humans; Axilla; Blood Loss, Surgical; Breast Neoplasms; Edema; Feasibility Studies; Lymph Node Excision; Mastectomy, Segmental; Paresthesia; Surgical Wound
PubMed: 37495629
DOI: 10.1038/s41598-023-39199-y -
Diagnostic and Interventional Radiology... Jul 2022PURPOSE This article will examine the usefulness of diffusion tensor imaging (DTI) and diffusion-weighted imaging (DWI) on the assessment of axillary lymph nodes (ALN)...
PURPOSE This article will examine the usefulness of diffusion tensor imaging (DTI) and diffusion-weighted imaging (DWI) on the assessment of axillary lymph nodes (ALN) of breast cancer patients. METHODS Axillary lymph nodes in 66 breast cancer patients were examined by DTI and DWI, and the largest lymph node with increased cortical thickness in axilla was selected. Morphological features, apparent diffusion coefficient (ADC), volume anisotropy, and fractional anisotropy values were measured by using a special software. Imaging findings and histopathological results were recorded. RESULTS Metastatic ALN were detected in 43 (65.1%) patients. Cortical thickness of the metastatic ALN was significantly higher than the non-metastatic ALNs (P < .001), and the long-axis-to-shortaxis ratio was significantly lower in metastatic ALNs (P < .001). There was a statistically significant difference between the ALN status and fatty hilum presence (P < .001). Apparent diffusion coefficient values of metastatic ALNs were statistically lower than those of non-metastatic ALNs (P < .001) using a cutoff value of 1.26 × 10-3 mm2 /s for b=500 ADC and 1.21 × 10-3 mm2 /s for b=800 ADC which had 97.7% sensitivity and 91.3% specificity. Fractional anisotropy and volume anisotropy values were significantly different between both groups. A cutoff value of 0.47 for b-500 fractional anisotropy had 83.7% sensitivity, 69.6% specificity 69.6% positive predictive value, and 83.7% negative predictive value. A cutoff value of 0.33 for b=500 volume anisotropy had 76.7% sensitivity, 78.3% specificity, 86.8% positive predictive value, and 64.3% negative predictive value. CONCLUSION Apparent diffusion coefficient value of metastatic ALNs was found to be significantly lower than those of non-metastatic ALN, and DTI metrics of metastatic ALN were found to be significantly higher than those of non-metastatic ALN. Overall, ADC had a better diagnostic performance than morphological features, fractional anisotropy, and volume anisotropy. Diffusion tensor imagingderived diffusion metrics may be used to complement breast magnetic resonance imaging in the future after further standardization of the imaging parameters.
Topics: Axilla; Breast Neoplasms; Diffusion Magnetic Resonance Imaging; Diffusion Tensor Imaging; Female; Humans; Lymph Nodes; Lymphatic Metastasis; Sensitivity and Specificity
PubMed: 35950277
DOI: 10.5152/dir.2022.21460