Due to the establishment of screening mammography for breast cancer detection, the number of non-palpable lesions has increased. Thus, an optimal localization system is mandatory for the excision of ...non-palpable breast tumors.
The aim of the study is to report the feasibility Surgical Marker Navigation (SMN) system Sirius Pintuition® for the excision of non-palpable breast tumors and non-palpable axillary lymph nodes.
A retrospective observational study of patients undergoing breast-conserving surgery and lymph node excision guided by SMN between December 2022 and May 2023 was performed.
A total of 84 patients underwent excision of non-palpable breast tumors (77; 91.7%) or non-palpable axillary lymph-nodes (7; 8.3%) using SMN. In total, 94 markers were placed, in 74 patients (88.1%) only one marker was placed, whereas in 10 patients (11.9%) two markers were placed to correctly localize the lesion in the operating room. Most markers were placed using ultrasonographic guidance (69; 82.1%). Seventy-seven patients underwent breast-conserving surgery (91.7%) and 7 (8.3%) lymph node excision. In 10 cases (11.9%), the marker was accidentally displaced during surgery due to the use of magnetized instruments, although the specimen could be removed. In sum, all the markers were removed from the patients, although the marker retrieval rate, as we defined it (percentage of patients in whom the initial excised specimen contained the marker divided by the total number of patients), was 88.1%.
The use of Sirius Pintuition® SMN for non-palpable breast tumors and non-palpable lymph nodes is feasible, with a retrieval rate of 88.1%.
Metastases from extramammary malignant neoplasms are very rare, accounting for less than 2% of all breast malignancies.
The aim of this study is to describe the clinicopathological features and ...prognosis of breast metastases from non-primary breast malignancies at our institution.
We performed a retrospective observational study, obtaining data from electronic medical records and pathology databases between January 1985 and December 2020 for patients diagnosed with breast metastasis from non-primary breast malignancies. Only patients diagnosed by biopsy were included.
Fifteen patients diagnosed with breast metastases from non-primary breast malignancies were included, 13 women (86,67%) and 2 men (13,33%). The median age at time of initial diagnosis was 56 years (IQR 21-68). The most frequent primary malignancy was melanoma (9/15; 60%). The median time to diagnosis of breast metastases was 65 months (IQR 13-106). The most common diagnostic modality was CT-scan (10/15; 66,67%). The median follow-up was 96 months (IQR 29-136). Eight patients underwent surgery (53,3%), being the most common surgical intervention breast-conserving surgery (5/8; 62,5%). Mortality at the end of follow-up was 53,3% (8/15). On the survival analysis, we found no differences between patients undergoing surgery and those only receiving systemic treatment 41,5 months (IQR 17,5-57,5) versus 14 months (IQR 2-24), respectively; p = 0,161.
Breast metastases from non-primary breast malignancies are extremely rare and represent a diagnostic and therapeutic challenge, due to the poor prognosis of these patients. Thus, arriving at the correct diagnosis is crucial to avoid unnecessary treatment in this population.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Introducción y objetivo:La infección por coronavirus (COVID-19) en pacientes intervenidos es causa de importante mortalidad postoperatoria, aunque su incidencia es variable. El objetivo primario fue ...evaluar la incidencia de COVID-19 en los pacientes intervenidos en nuestro Servicio de Cirugía General y Digestiva, durante el máximo impacto de la pandemia en España. El objetivo secundario fue evaluar la mortalidad perioperatoria y determinar los factores de riesgo para la infección por COVID-19.Material y métodos:Estudio observacional retrospectivo de pacientes consecutivos sometidos a Cirugía General y Digestiva con ingreso superior a 24 horas, del 1 de febrero de 2020 al 30 de abril de 2020 en un hospital terciario de Madrid, España.Resultados:Se analizaron 441 pacientes: 423 sin COVID-19 y 18 con COVID-19. Las características preoperatorias y operatorias fueron similares para ambos grupos, salvo por el grado ASA (American Society of Anesthesiologists).La incidencia de COVID-19 en los pacientes intervenidos fue del 4,1 %. La mortalidad postoperatoria fue elevada, del 22,2 % en pacientes con COVID‑19, frente a un 2,8 % en pacientes no COVID‑19 (p: 0,003). Los factores de riesgo para la infección por COVID-19 en los pacientes intervenidos fueron una estancia hospitalaria prolongada (OR: 1,035 95 % CI: 1,007 ‑ 1,065) y la reintervención quirúrgica (OR: 5,025 95 % CI: 1,650 – 15,311).Conclusión:Las intervenciones durante la pandemia de COVID-19 causaron una baja tasa de infección con elevada mortalidad postoperatoria. La intervención quirúrgica debe valorarse frente al riesgo adicional para el paciente en contextos de alta transmisión.
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