Marking axillary nodes with 4% carbon microparticle suspension before neoadjuvant chemotherapy improves sentinel node identification rate and axillary staging.

BACKGROUND AND OBJECTIVES: Marking positive lymph nodes (LNs) before neoadjuvant chemotherapy (NAC) may improve the accuracy of sentinel lymph node biopsy (SLNB). The aim of this study was to determine the feasibility of marking LNs with 4% carbon microparticle suspension (CMS) before NAC and to evaluate if this technique would improve the SLNB identification rate. METHODS: A prospective study of patients with cT1-T4, cN1-N2 breast cancer who underwent US-guided fine-needle aspiration biopsy (FNAB) of suspected LNs and concomitant marking with 4% CMS was performed. After NAC, LNs marked with 4% CMS and those marked with Patent Blue V dye (PBV) were identified and resected. RESULTS: Of the 123 patients included, 74 (60.1%) had positive LNs at FNAB. During axillary surgery, 4% CMS was identified in 121 of 123 patients (98.3%) and blue sentinel LNs in 91% (112 of 123 patients) (P = .0103). Comparing isolated results of PBV and 4%CMS + PBV, the association was better in identifying positive LNs (72.2% vs 97.7%) (P = .02). CONCLUSION: The association of 4% CMS and PBV is feasible and significantly increased the identification rate of positive LNs. 4% CMS may play an important role as a complementary technique in patients submitted to NAC.

Invasive lobular carcinomas treated at Hospital de Clínicas of UFPR: incidence, characteristics and clinical outcome / Carcinomas lobulares invasores de mama tratados no Hospital de Clínicas da UFPR: incidência, características e evolução clínica

Objective: The aim of this study is to depict the clinical and epidemiological profile of patients treated for invasive lobular carcinoma (ILC) at Hospital das Clínicas of Universidade Federal do Paraná (HC-UFPR) over the course of ten years and to evaluate the variation of ILC dimensions on imaging exams by comparing them to real-size lesions identified in surgical specimens. Methods: Patients undergoing breast surgical procedures at HC-UFPR from 2005 to 2014 were selected. Out of these, 36 were diagnosed with ILC and had their medical files sought after clinical, epidemiological, therapeutic and prognosis characteristics. The variance of tumor sizes in imaging methods and anatomopathological descriptions were also studied. Results: Patients' mean age at diagnosis was 59.6 years. Most of them were classified as clinical stages II (40%) and III (26.7%) by the time they were diagnosed. The majority of tumors were HER2 negative (77.2%) and estrogen-receptor positive (90%). The surgical treatment was radical in 74.2% of the cases. 31.4% of the patients underwent both mammography and ultrasonography screening and 45.7% underwent only one of them. None of the patients were submitted to magnetic resonance imaging (MRI). Conclusion: Data found about patients with invasive lobular carcinoma at HC-UFPR is in accordance with the medical literature, including incidence rates and tumor characteristics. The variance of tumor sizes in imaging exams and surgical specimen was not statistically significant

Objetivo: O estudo busca caracterizar o perfil clínico epidemiológico referente às pacientes tratadas por carcinoma lobular invasor de mama (CLI) no Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR) em um período de dez anos e avaliar as variações das dimensões dos CLI nos exames de imagem quando comparadas ao real tamanho das lesões identificadas nas peças de anatomia patológica. Métodos: Foram selecionadas pacientes submetidas a procedimentos cirúrgicos de mama no HC-UFPR entre os anos de 2005 e 2014, dentre as quais 36 apresentaram diagnóstico de CLI. Seus prontuários foram analisados para avaliação de características clínicas, epidemiológicas, terapêuticas e prognósticas. Também foi avaliada a discrepância dos valores de tamanho do tumor em métodos de imagem em relação ao descrito nos laudos anatomopatológicos. Resultados: A s p acientes c om d iagnóstico d e C LI tinham média de idade no diagnóstico de 59,6 anos. O diagnóstico foi feito, em sua maioria, nos estádios clínicos II (40%) e III (26,7%). Houve maior negatividade (77,2%) para HER2 e positividade (90%) para receptor de estrógeno. O tratamento cirúrgico foi radical em 74,2% das pacientes. Em exames de imagem, 31,4% das pacientes realizaram mamografia e ultrassonografia em conjunto, 45,7% fizeram apenas um dos exames e nenhuma realizou ressonância magnética. Conclusão: Observou-se que a casuística de patologias mamárias do HC-UFPR está de acordo com a literatura em relação à incidência e às características próprias dos CLI. A análise da discrepância dos tamanhos dos tumores em exames de imagem em relação às peças cirúrgicas não obteve resultados significativos estatisticamente