Breast carcinoma grading on core needle biopsy - to grade or not to grade?

Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease and the basis for the treatment planning. The concordance rate between CNB and surgical excision specimen in determination of histological grade (HG) varies widely across literature, ranging from 59-91%. The aim of our study was to investigate the level of concordance between CNB and surgical excision specimen for the determination of HG for breast cancer patients. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. The concordance level between core needle biopsy and surgical resection specimen for overall histologic grading was 73%: for tubule formation - 71%, for nuclear pleomorphism - 91%, for the mitotic index - 59%. Our study shows that our institution's histologic grading of CNBs and surgical excisions shows a fairly good correlation and is useful for the planning of treatment.

Dermoid Cyst of the Parotid Gland: Case Report of a Rare Entity and Review of the Literature.

BACKGROUND A dermoid cyst is a benign, epithelial-lined cavitary lesion composed of ectoderm and mesoderm that can arise anywhere in the body, with a tendency to develop in midline structures such as the coccyx and ovary. It is a rare entity in the head and neck region, where the incidence is 7% of all body dermoid cysts. Of these 7% (dermoid cysts found within the head and neck area), 80% are found localized to areas around the orbit, oral region, and nasal region. Within the parotid gland, they are extremely rare, with less than 25 cases reported in the existing literature. CASE REPORT We report a case of a 26-year-old woman with a long-standing left parotid mass that was found to be a dermoid cyst after surgical excision and histological evaluation. We examine the clinical presentation and imaging findings used to establish a presumptive diagnosis to guide treatment options. Although preoperative fine-needle aspiration was not performed in this case, it is often used to clarify the differential diagnosis before definitive surgical management is undertaken. CONCLUSIONS Intraparotid dermoid cysts are rare, benign entities that require complete cystectomy for definitive management. As surgical excision is the only curative method, preoperative histopathological diagnosis via biopsy may be unnecessary. Our paper adds to the existing literature by presenting a case of an intraparotid dermoid cyst successfully treated surgically in a 26-year-old woman.

Implementation of electronic health records in Polish outpatient health care clinics - starting point, progress, problems, and forecasts.

INTRODUCTION: The Act on Information System in Health Care, dated 28 April 2011, imposes an obligation to record patients' medical documentation in an electronic form (EHR - Electronic Health Records) on the providers of health care services, starting from 1 August 2014. On 23 July 2014, an amendment of the Act was enacted, based on which the date of obligatory introduction of health records in paper or electronic form was postponed until 31 July 2017. At various health care entities there are two different methods of creating health records (HR); therefore, the implementation of the provisions of the Act poses a significant number of problems and complications. OBJECTIVE: The objective of the study is to present the starting point, progress, problems and forecasts regarding the implementation of electronic health records at health care entities which provide services within the scope of specialized outpatient care (SOC). MATERIALS AND METHOD: The subjects of this research were 475 health care entities which provide services within the scope of specialized outpatient care (SOC) operating in Poland. The applied research tool was a survey questionnaire. The applied research technology was a Computer Assisted Web Interview (CAWI). The research was conducted between February - April 2014. The data was analyzed with the chi-squared test of independence. RESULTS: In the period of the research, 233 health care entities were at the stage of preparation for the implementation of HER: 116 - in the process of implementation; 72 - after implementation, and only 54 were already recording their documentation in an electronic form. CONCLUSIONS: Most health care entities providing specialized outpatient care would not have complied with the provisions of the Act on Information System in Health Care had the deadline for implementation of EHR not been postponed. Five months before the date stipulated in the first version of the Act (August 2014), about 74% of health care entities covered by this study did not yet have a ready EHR system. The study also showed that 2 years is insufficient time for the entire process of informatization of a health care establishment.