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1.
Gland Surg ; 12(10): 1387-1394, 2023 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-38021204

RESUMO

Background: Accurate breast volume estimation is essential for symmetrical breast reconstruction. Easy conversion of the weight of the resected breast tissue to volume could result in precise volume measurements. This study aimed to introduce the use of a mathematical constant (k) to estimate the breast volume from the weight. Methods: Eighty-nine female patients with breast cancer who underwent surgery at King Chulalongkorn Memorial Hospital between September 2010 and February 2011 were enrolled in this prospective study. The mammographic density of each patient was classified according to the breast imaging reporting and data system (BI-RADS) into groups a, b, c, and d. The breast density number and mathematical constant (k) were calculated, and the data matched. This technique was validated by comparing the measured and calculated volumes. Results: Sixty-six, 22, and 1 patients underwent total mastectomies (TMs), skin-sparing mastectomies (SSMs), and nipple-sparing mastectomies (NSMs), respectively. The breast densities were 1.0629, 1.1545, and 1.2233 g/mL, and the constant number (k) was 0.9409, 0.8662, and 0.8175 for BI-RADS a, combined BI-RADS b and c, and BI-RADS d, respectively. The validation process showed no significant differences between the measured and calculated volumes [95% confidence interval (95% CI)]. The correlation coefficient (r) was 0.984. Conclusions: Accurate breast volume estimation is a key factor in achieving symmetry in breast reconstruction. Combining existing data, including the weight of the resected breast tissue and mammographic density findings, an easy and accurate method to calculate the resected breast volume was introduced.

2.
J Med Assoc Thai ; 89(2): 236-41, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16579012

RESUMO

OBJECTIVES: To evaluate the accuracy of using radiologic, cytologic and integrated radiologic and cytologic criteria in diagnosis of nonpalpable breast lesions. MATERIAL AND METHOD: From January 2003 to May 2004, a prospective study of performing fine-needle aspiration biopsy (FNAB) was carried out at King Chulalongkorn Memorial Hospital on female patients with nonpalpable or vaguely palpable lumps that needed ultrasound localization for the direction and depth. RESULTS: There were 162 lesions from 150 patients, consisting of 29 malignant neoplasms (17.9%) and 133 benign lesions (82.1%). Of the 107 classified as subcentimeter focal lesions (< 1 x 1 cm2 in size), two of radiological malignancy were false and two others were falsely negative by cytology. While the 23 large/ill-defined lesions (> 1.5 x 1.5 cm2 in size), one hiding malignant lesion adjacent to a prominent intraduct papilloma was missed. Two others had falsely negative cytologic diagnosis. The integrated criteria achieved accuracy and sensitivity of 97.5% and 93% compared with the cytology, 96.3% and 82.8% and the better scenario of radiology, 95.7% and 82.8% respectively. CONCLUSION: The integrated criteria provide the most accuracy rate and sensitivity rate for detection of malignancy in nonpalpable breast lesions.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina , Neoplasias da Mama/mortalidade , Carcinoma/mortalidade , Estudos de Coortes , Feminino , Humanos , Imuno-Histoquímica , Masculino , Mamografia/métodos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Medição de Risco , Sensibilidade e Especificidade , Análise de Sobrevida
3.
J Med Assoc Thai ; 88(10): 1367-72, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16519381

RESUMO

OBJECTIVES: To assess the proportions of response to neoadjuvant chemotherapy of breast cancer according to color Doppler ultrasound vascularity patterns. MATERIAL AND METHOD: Prospective evaluation using gray scale and color Doppler ultrasound for number of vessels and feeding appearances of tumors as well as the changes in tumor sizes at before and after chemotherapy in 69 breast cancer patients. RESULTS: The overall response rate in 70 breast cancers was 20%. Twenty-nine lesions (41%) showed hypervascularity and 41 lesions (59%) revealed hypovascularity. There were 5 vascularity patterns and each pattern had the proportion of responders as follows; 33.3% for hypovascularity with single-vessel feeding into the tumor, 25% for hypovascularity with single-vessel feeding at periphery of the tumor, 25% for no vascular feeding to the tumor, 16.7% for hypervascularity with vascular feeding at the periphery of the tumor and 13% for hypervascularity with vascular feeding into the tumor. The highest percentage of responsive group was the pattern of hypovascularity with single-vessel feeding into the tumor (33.3%). CONCLUSION: There is a trend that tumor vascularity and patterns of vascular feeding by color Doppler ultrasound can predict the responsiveness of breast cancer to neoadjuvant chemotherapy.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias da Mama/irrigação sanguínea , Neoplasias da Mama/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Idoso , Neoplasias da Mama/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Terapia Neoadjuvante , Valor Preditivo dos Testes , Resultado do Tratamento
4.
J Med Assoc Thai ; 86 Suppl 2: S284-90, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12930001

RESUMO

OBJECTIVE: To evaluate the efficacy of combined fine needle aspiration (FNA) and ultrasonography in the diagnosis of impalpable breast lesions. METHOD: To analyze the diagnostic performance of the FNA cytology and ultrasound among female patients with impalpable breast lesions that were referred to the FNA clinic at King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University in Bangkok, Thailand during the period of July 2001 to June 2002. The final diagnoses employed surgical pathology and 6-month follow-up of the patients. RESULT: In a-year-period of the studied frame, there were 57 studied cases (18.3% of the total FNA breast cases). To diagnose malignant lesions, FNA cytology achieved the sensitivity of 61 per cent and the specificity of 100 per cent, whereas, diagnostic radiology had a sensitivity of 100 per cent and specificity of 56.1 per cent. The FNA cytology was superior to ultrasound in the determination of inflammatory lesions while imaging was dominant in the hard-to-aspirate malignant lesions. Therefore, the combined cyto-radiology criteria could correctly diagnose malignancy in all cases (100% accuracy). CONCLUSION: The efficacy of combined FNA and ultrasonography in the diagnosis of impalpable breast lesions was highly satisfactory. The accuracy of each technique enhanced each other and gave the correct diagnosis in all cases.


Assuntos
Biópsia por Agulha , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Palpação , Ultrassonografia Mamária , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
5.
J Med Assoc Thai ; 85 Suppl 1: S193-202, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12188412

RESUMO

A retrospective review was performed on 576 patients who have been diagnosed breast cancer and referred to Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between January 1995-September 2001. There were three hundred ninety nine cases of invasive breast cancer that available for estrogen (ER) and/or progesterone (PR) receptor status. The mean and median age in our study were 49.6 year and 49.0 year respectively. About 60.9 per cent of the patients were pre and peri-menopause and 37.8 per cent were post-menopause. Most of the histological cell type were invasive ductal carcinoma which comprised of 92.7 per cent. Histologic grading were nearly equal for moderately and poorly differentiated grade: 43.66 per cent and 40.66 per cent. The results of our study showed 53.4 per cent of 399 patients had ER positive and 42.1 per cent of 380 patients had PR positive. The proportion of ER+PR+, ER+PR-, ER-PR+, and ER-PR- were 36.31 per cent, 15.53 per cent, 5.79 per cent and 42.37 per cent respectively. Older age and post-menopause women had higher ER+. While patients with increase tumor size, poorly differentiated grading, increase positivity of axillary lymph nodes and higher stage have more chance of ER negative and PR negative.


Assuntos
Biomarcadores Tumorais/análise , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Neoplasias da Mama/metabolismo , Carcinoma Ductal de Mama/metabolismo , Climatério , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pós-Menopausa , Prognóstico , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Estudos Retrospectivos , Sensibilidade e Especificidade
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