RESUMEN
PURPOSE: To assess the feasibility and effectiveness of radiofrequency ablation (RFA) in breast cancer, using different histopathologic staining methods to evaluate tissue viability. MATERIALS AND METHODS: In twenty patients with unifocal small (≤1, 5 cm) invasive ductal carcinoma, ultrasound-guided RFA was performed immediately after surgery. Cell viability was assessed using cytokeratin 8 (CK 8) and nicotinamide adenine dinucleotide diaphorase (NADHD) in addition to hematoxylin-eosin (HE). RESULTS: At histopathological examination, ex vivo RFA resulted in complete cell death of the target lesion in 17/20 patients. In two cases viable ductal carcinoma in situ (DCIS) was found just outside the completely ablated lesion. CONCLUSION: RFA of small invasive breast cancer seems to be a feasible treatment option. Both NADHD and CK 8 demonstrate a clear and comparable demarcation between viable and non-viable tissue. A high level of accuracy is required in proper positioning of the needle electrode and a "hot retraction" is mandatory.
Asunto(s)
Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/cirugía , Ablación por Catéter/métodos , Cirugía Asistida por Computador/métodos , Ultrasonografía Mamaria/métodos , Anciano , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/patología , Carcinoma Intraductal no Infiltrante/patología , Carcinoma Intraductal no Infiltrante/cirugía , Supervivencia Celular , Estudios de Factibilidad , Femenino , Humanos , Técnicas In Vitro , Mastectomía , Mastectomía Segmentaria , Persona de Mediana Edad , Resultado del Tratamiento , Ultrasonografía Intervencional/métodosAsunto(s)
Aneurisma/diagnóstico por imagen , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Anomalías Cardiovasculares/diagnóstico por imagen , Trastornos de Deglución/diagnóstico por imagen , Anciano , Aneurisma/complicaciones , Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/complicaciones , Anomalías Cardiovasculares/complicaciones , Medios de Contraste , Trastornos de Deglución/complicaciones , Diagnóstico Diferencial , Femenino , Humanos , Imagenología Tridimensional/métodos , Intensificación de Imagen Radiográfica/métodos , Arteria Subclavia/anomalías , Arteria Subclavia/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodosAsunto(s)
Dolor Abdominal/etiología , Enfermedades del Íleon/complicaciones , Intususcepción/complicaciones , Intususcepción/cirugía , Adulto , Procedimientos Quirúrgicos del Sistema Digestivo , Humanos , Enfermedades del Íleon/patología , Enfermedades del Íleon/cirugía , Intususcepción/diagnóstico , MasculinoRESUMEN
Breast cancer is an important health care problem, especially in the increasing elderly generation. Treatment of these fragile patients is a challenge for the clinician. Undertreatment has been linked to a higher percentage of recurrence and cancer related morbidity, while overtreatment leads to treatment related morbidity and mortality. Minimally invasive techniques do offer new opportunities for patients, who are no candidates for conventional surgery. The tumor lesion is treated locally and selective with minimal damage to surrounding tissue, yielding an adequate local tumor control. Radio frequency ablation technique seems an effective and safe method for treatment of the elderly patient with small (< 3 cm) breast cancer.
Asunto(s)
Neoplasias de la Mama/cirugía , Ablación por Catéter/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/mortalidad , Femenino , Humanos , Resultado del TratamientoRESUMEN
Two patients with splenic bleeding were treated with transcatheter embolisation and selective coiling of the splenic artery. These were first of all a 78-year-old woman who was on anticoagulants for atrial fibrillation and suffered a laceration of the spleen with extravasation of contrast medium and a falling haemoglobin level. The second patient was a 23-year-old woman who suffered laceration of the spleen as the result of a traffic accident. Embolisation made it possible to avoid surgical treatment and preserve the spleen in both patients. Selective embolisation of the splenic artery is a useful adjunct to the non-operative management of patients with traumatic splenic injury. However, the proper patient selection still needs to be established.