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BMC Women's Health Apr 2021Patients with fibroadenomas in axillary accessory breasts (AABs) have a palpable mass, cyclic axillary pain, and aesthetic concerns that must be addressed. We compared...
BACKGROUND
Patients with fibroadenomas in axillary accessory breasts (AABs) have a palpable mass, cyclic axillary pain, and aesthetic concerns that must be addressed. We compared the baseline patient characteristics, AAB characteristics, and surgical outcomes of patients with AABs with and without fibroadenomas undergoing surgical excision. We also monitored the patients for recurrence of axillary fibroadenomas.
METHODS
This retrospective study involved 2310 women who underwent AAB excision from 2014 to 2019. Patients with and without a palpable fibroadenoma were divided into a fibroadenoma group and non-fibroadenoma group, respectively. All patients underwent complete excision of accessory mammary gland (AMG) tissue, including fibroadenomas in the AABs. We removed the fibroadenoma and the AMG tissue with a minimal axillary incision.
RESULTS
Thirty-nine patients had a palpable fibroadenoma in the AAB, and all patients in the fibroadenoma group had cyclic axillary pain and a palpable axillary mass. There were no significant differences in the patients' age, weight of the AMG tissue, liposuction volume, or fibroadenoma laterality between the two groups. The body mass index in the fibroadenoma group was lower than that in the non-fibroadenoma group (19.9 vs. 22.3 kg/m, respectively; P < 0.000). Concurrent fibroadenoma excision in a normal breast on the chest was performed more often in the fibroadenoma group than in the non-fibroadenoma group (35.9% (14/39) vs. 4.1% (92/2271), respectively; P < 0.000). The mean fibroadenoma size was 2.1 cm (range, 1.1-9.1 cm). All patients were satisfied with the degree of postoperative pain relief, disappearance of palpable lesions, and cosmetic improvement. No patients developed fibroadenoma recurrence.
CONCLUSIONS
Complete excision of the AMG tissue and fibroadenoma is appropriate in patients with an AAB with a fibroadenoma. Surgeons should also consider the high incidence of concurrent fibroadenomas in the normal breasts on the chest.
Topics: Axilla; Breast; Breast Diseases; Breast Neoplasms; Female; Fibroadenoma; Humans; Neoplasm Recurrence, Local; Retrospective Studies
PubMed: 33827532
DOI: 10.1186/s12905-021-01278-5 -
Breast Cancer (Tokyo, Japan) 2005In Japan, mammography was endorsed for breast cancer screening in women aged 40 and over by the Ministry of Health, Labor and Welfare in 2004. The spread of mammographic... (Review)
Review
In Japan, mammography was endorsed for breast cancer screening in women aged 40 and over by the Ministry of Health, Labor and Welfare in 2004. The spread of mammographic screening has caused an increase in the incidence of non-palpable breast cancer. Precision reading for mammography is necessary to detect non-palpable breast cancer. When mass and focal asymmetric density is noted, it is important to analyze the density, density gradient, internal structure, margin and associated findings. Calcifications are classified by morphology and distribution mainly. It is necessary to distinguish secretor-type calcifications from necrotic-type calcifications. The Iwate Cancer Association performed a population-based screening program for breast cancer using mammography combined with clinical breast examination of 42,065 women in Iwate Prefecture from 1999 to 2003. A total of 2,329(5.7%)women were recalled and the 112 cases(0.27%) of cancer were detected in 114 breasts. Of 114 breast cancers, 40 (35%) were non-palpable and 74(65%) were palpable. The early breast cancer (stage 0 and I) rate of the non-palpable group was significantly higher than that of the palpable group (90% and 47%, p = 0.0003). The node-negative rate of the non-palpable group was significantly higher than that of the palpable group (92% and 68%, p = 0.011). It is expected that mammographic screening will be expanded and that the mortality rate from breast cancer in Japan will decrease, as in Europe and the United States.
Topics: Breast Neoplasms; Female; Humans; Japan; Lymphatic Metastasis; Mammography; Mass Screening; Physical Examination; Sensitivity and Specificity
PubMed: 16286905
DOI: 10.2325/jbcs.12.258 -
AJNR. American Journal of Neuroradiology Apr 1998A definition of cut-off points for nodal size is essential to determine whether cervical lymph nodes are metastatic or not. Because the currently used size criteria are... (Review)
Review
PURPOSE
A definition of cut-off points for nodal size is essential to determine whether cervical lymph nodes are metastatic or not. Because the currently used size criteria are defined for random populations of patients with head and neck cancer, we set out to study whether these criteria are optimal for patients without palpable metastases in different levels of the neck We defined optimal size criteria for sonography by calculating the sensitivity and specificity of different size cut-off points.
METHODS
We compared the sensitivity and specificity of different size cut-off points as measured on sonograms for various levels in the neck in a series of 117 patients with and 131 patients without palpable neck metastases.
RESULTS
A minimum axial diameter of 7 mm for level II and 6 mm for the rest of the neck revealed the optimal compromise between sensitivity and specificity in necks without palpable metastases. For all necks together (with and without palpable metastases), the criteria were 1 to 2 mm larger.
CONCLUSION
Our findings indicate that the current sonographic size criteria used for random patient populations are not optimal for necks without palpable metastases, nor can the same cut-off points be used for all levels in the neck.
Topics: Evaluation Studies as Topic; Humans; Lymph Nodes; Lymphatic Metastasis; Neck; Sensitivity and Specificity; Ultrasonography
PubMed: 9576657
DOI: No ID Found -
Translational Andrology and Urology Oct 2017Positron emission tomography (PET) imaging with F-fluorodeoxyglucose (FDG) combined with computed tomography (CT) provides functional imaging combined with anatomic... (Review)
Review
Positron emission tomography (PET) imaging with F-fluorodeoxyglucose (FDG) combined with computed tomography (CT) provides functional imaging combined with anatomic information, improving diagnostic accuracy and confidence. Although virtually all primary penile tumors are FDG-avid, PET/CT is not recommended for primary tumor staging as it has limited spatial resolution and is hampered by urinary FDG excretion. The accuracy of PET/CT for lymph node staging seems to improve with the pretest likelihood of metastatic nodes. In groins with normal physical examination, sensitivity is only 57%. In groins with palpably enlarged lymph nodes, sensitivity of PET/CT reaches 96%. For pelvic lymph nodes and distant metastases, PET/CT is more accurate if inguinal metastases are present. However, these results are based on a very limited number of studies. Overall, the role of PET/CT imaging in penile cancer remains ambiguous, especially in inguinal lymph nodes. During staging and follow-up, it may be particularly useful in detecting pelvic lymph node metastases and occult distant metastases prior to systemic chemotherapy and/or extensive surgery, improving selection of patients that are most likely to benefit from such therapies.
PubMed: 29184780
DOI: 10.21037/tau.2017.04.36 -
In Vivo (Athens, Greece) 2021Wire-guided localization is the gold-standard for the detection of non-palpable breast lesions, although with acknowledged limitations. The aim of this study was to...
BACKGROUND
Wire-guided localization is the gold-standard for the detection of non-palpable breast lesions, although with acknowledged limitations. The aim of this study was to evaluate the combined use of LOCalizerr™ (Hologic, Santa Carla, CA, USA), and intraoperative ultrasound (IOUS) for localization and surgery of non-palpable breast cancer.
PATIENTS AND METHODS
Patients with non-palpable breast lesions underwent localization procedure with LOCalizer™ and IOUS. After the placement of the marker, eight measures were made to guide the excision. LOCalizerr™ Pencil and IOUS were performed to obtain the distance between the dissection plane and the margins of lesions.
RESULTS
The procedure was feasible in the five enrolled patients and associated with clear oncological margins in all cases. Moreover, a high satisfaction according to Likert scale for surgeons, radiologists and patients, performing limited and tailored resections, was reported.
CONCLUSION
Combining LOCalizerr™ and IOUS is an effective method for locating non-palpable breast cancer, guarantying excellent oncological and cosmetic results.
Topics: Breast; Breast Neoplasms; Female; Humans; Margins of Excision; Ultrasonography; Ultrasonography, Mammary
PubMed: 33910851
DOI: 10.21873/invivo.12426 -
Plastic and Reconstructive Surgery.... Sep 2017The development of acellular dermal matrices (ADMs) has facilitated single-stage implant breast reconstruction (IBR) following skin-sparing mastectomy. The conventional...
BACKGROUND
The development of acellular dermal matrices (ADMs) has facilitated single-stage implant breast reconstruction (IBR) following skin-sparing mastectomy. The conventional approach of postpectoral implant placement with lower pole ADM confers a good cosmetic result by improving lower pole projection and control, while minimizing issues of implant visibility, palpability, and rippling. This is balanced with potential disadvantages including pain, disruption of pectoral muscle function, and animation. We report the results of a prospective study of prepectoral IBR with total ADM coverage.
METHODS
Prepectoral IBR with total ADM coverage was performed in 106 patients (166 breasts) in our institution from 2013 to 2017. The cohort included patients undergoing immediate IBR (113 breasts) and revision of existing submuscular IBR (53 breasts). Patient demographics, surgical complications, and outcomes from a prospective database were analyzed.
RESULTS
At a mean follow-up of 485 days, patient satisfaction and cosmetic outcomes have been good, with no significant capsular contractures or animation deformity. Minor complications including delayed healing, red breast, or seroma occurred in 14 breasts (8.4%). Major complications including necrosis and implant loss occurred in 5 breasts (3 patients), with a total explantation rate of 3%. No patients required more than an overnight stay in hospital, and there were no delays to adjuvant treatment in therapeutic cases.
CONCLUSION
Prepectoral implant placement with ADM cover is emerging as an alternative approach for IBR. This method facilitates breast reconstruction with a good cosmetic outcome for patients who want a quick recovery without potential compromise of pectoral muscle function and associated problems.
PubMed: 29062655
DOI: 10.1097/GOX.0000000000001488 -
Radiology Case Reports May 2023Mammary fibromatosis is a rare neoplastic proliferation of fibroblastic cells. Usually seen in abdominal and extra-abdominal sites, it is rarely seen in the breast....
Mammary fibromatosis is a rare neoplastic proliferation of fibroblastic cells. Usually seen in abdominal and extra-abdominal sites, it is rarely seen in the breast. Patients with mammary fibromatosis usually present with a firm palpable mass with or without dimpling and skin retraction-often mimicking breast carcinoma. Here, we present a case of mammary fibromatosis in a 49-year-old woman who presented with a palpable lump in her right breast. Mammography tomosynthesis revealed architectural distortion which was seen on ultrasonography as a hypoechoic area. The patient underwent a wire-guided excision where the histology of this specimen showed irregular spindle cell proliferation with hemosiderin deposition, confirming mammary fibromatosis. Further re-excision of margins revealed no evidence of residual fibromatosis, and the patient underwent subsequent surveillance mammograms to ensure there was no recurrence.
PubMed: 36970238
DOI: 10.1016/j.radcr.2023.02.019 -
Radiologia 2023Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology...
Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology books do not cover some of them. This series of two articles aims to review the clinical and radiological characteristics of a selection of palpable tumors in children that radiologists need to be familiar with.
Topics: Humans; Child; Fibroma; Soft Tissue Neoplasms; Diagnostic Imaging
PubMed: 36842785
DOI: 10.1016/j.rxeng.2023.01.001 -
Archives of Plastic Surgery Jan 2022
PubMed: 35086323
DOI: 10.5999/aps.2021.01704 -
Journal of Children's Orthopaedics Dec 2020This article prospectively examines the functional outcome measures following management of vascular insult secondary to paediatric supracondylar humerus fractures...
PURPOSE
This article prospectively examines the functional outcome measures following management of vascular insult secondary to paediatric supracondylar humerus fractures (SCHFX) using validated outcome measures.
METHODS
The three-year, prospective, IRB-approved study consecutively enrolled operative SCHFX patients. Clinical data included presence and symmetry of the radial pulse in injured and uninjured extremities, Doppler examination of non-palpable (NP) pulses and perfusion status of the hand. Pediatric Outcomes Data Collection Instruments (PODCI) and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) Measures were used to assess functional outcome at final follow-up. Multiple regression analysis was used to determine the relationship between the presence of a vascular abnormality and functional outcome while controlling for other injury parameters.
RESULTS
A total of 146/752 enrolled patients (mean age 6.8 years; range 2 years to 13 years) completed functional outcome measures at final follow-up. Of these, 20 (14%) patients had abnormal vascular exams at presentation: nine (6%) with palpable asymmetric pulse and 11 (7.5%) with NP pulse. Of those with NP pulses, nine/11 (6%) were Dopplerable and two (1.5%) lacked identifiable Doppler signal. Patients with a symmetric, palpable pulse demonstrated better PODCI pain and comfort scores (95.2 85.2) (p < 0.0001), and QuickDASH scores (10.9 21.6) (p < 0.007) compared to those with any abnormal vascular examination. Patients with palpable pulses, regardless of symmetry, demonstrated significantly higher PODCI pain and comfort scores (94.6 84.7) (p < 0.003) than NP pulses.
CONCLUSIONS
In children with operative SCHFX, an abnormal vascular examination at presentation is predictive of poorer outcomes in pain and upper extremity function. A palpable pulse, NP, is predictive of better pain and comfort at final follow-up.
LEVEL OF EVIDENCE
II.
PubMed: 33343743
DOI: 10.1302/1863-2548.14.200130