RESUMEN
BACKGROUND: Robust surveillance of injury aetiology and epidemiology is recognised as fundamental for effective injury reduction and management programmes. However, while sex-specific differences in injury type and nature are noted in the literature, it is unclear if these are reflected in surveillance practices, and how the athlete is affected. OBJECTIVE: Therefore, this study aimed to systematically review contact breast injuries (CBIs) among adult female athletes. METHODS: The following databases were searched: PubMed, EMBASE, SPORTDiscus including MEDLINE, Web of Science and Scopus. The literature search was conducted in May 2023 and the search was limited to articles in the English and German language. Studies including female athletes, aged 18 years and above, in any sports (team or individual) at any level (amateur, semi-professional and professional), where an occurrence of CBI was documented were included. Studies were included irrespective of their investigated timeframes (e.g. the whole career, one or multiple seasons). Findings were categorised (e.g. sport, level of competition and investigated timeframe of the study) to enable possible comparisons. Case studies were excluded due to the non-generalisability of findings. RESULTS: Of the six studies included, rugby codes (rugby union, rugby league and rugby sevens) had the highest occurrence rate (62.0%) of CBIs among eight different investigated sports (rugby codes 62.0%, softball 59.5%, Australian Football League (AFL) 51.0%, water polo 50.0%, soccer 46.7%, basketball 27.6-48.8%, volleyball 34.6%, boxing 0.0%). Between 25.6% and 62.0% of participants reported incurring a CBI and between 0.0% and 42.9% of CBIs were reported to a medical professional or support staff. The reported treatment rate for CBIs ranged between 0.0% and 2.1%, The main mechanisms for CBIs (where reported) were contact with another athlete (AFL 37.6%, rugby codes 56%) the ball (AFL 31.6%, rugby codes 25.5%) and the ground (AFL 6.6%, rugby codes 22%). Between 18.2% and 48% of the participants reported that CBIs negatively affected their performance. Risk factors increasing CBIs were positional differences, larger breast size and higher body mass index (BMI). In-season injury data collection and surveillance supported through education of both players and medical staff were identified to be of relevance for future CBI prevention. None of the studies reported incidence rate. CONCLUSION: Despite the frequent occurrence of CBIs among female athletes, reporting and treatment remains low. Awareness and education of all stakeholders are fundamental to ensuring better breast safety in female sport. Identifying the mechanics, severity and risk factors of CBIs through thorough injury surveillance must be a focus of further research. REGISTRATION: The study was preregistered on Open Science Framework (OSF).
Asunto(s)
Traumatismos en Atletas , Mama , Humanos , Femenino , Traumatismos en Atletas/epidemiología , Mama/lesiones , Fútbol Americano/lesiones , Adulto , Factores de Riesgo , Baloncesto/lesionesRESUMEN
Introducción: las lesiones B3 comprenden un grupo heterogéneo de lesiones proliferativas epiteliales de mama que suponen un riesgo variable de aparición subsiguiente de carcinoma. Nuestro objetivo es analizar el manejo de las lesiones B3 en nuestro centro entre 2017 y 2021 y compararlo con las recomendaciones de los consensos internacionales. Material y métodos: análisis descriptivo retrospectivo. Se incluyeron en el estudio todos los pacientes con diagnóstico histológico (por BAG o BAV) de lesión de mama B3, intervenidos o no, en el periodo indicado. Resultados: se identificaron 79 casos. Se realizó BAG en el 83,54% de los casos y BAV en el 16,45%. El 80,3% de las BAG realizadas fueron diagnósticas de LP, en 6 casos HDA y en 5 casos TF. Se realizó BAV en 11 casos. Se indicó intervención quirúrgica en el 97,46% de los casos. El análisis anatomopatológico de la pieza quirúrgica mostró en el 63,63% de los casos LP sin atipia. Cinco casos (6,49%) fueron diagnosticados de CLIS, 5 casos de CDIS, 4 casos de TF benigno y 4 casos de HDA. Dos casos fueron diagnosticados de CR y de HD usual. Discusión: el manejo de las lesiones B3 llevado a cabo en nuestro centro está marcado por el sobretratamiento respecto a las recomendaciones de los consensos. Una adaptación más estricta a las recomendaciones vigentes, la discusión de los casos en el CMD, que incluya la correlación radio-patológica y la evaluación de la lesión residual, y el uso más frecuente de BAV podría disminuir esta tendencia. (AU)
Introduction: B3 lesions comprise a heterogeneous group of proliferative epithelial lesions of the breast that pose a variable risk of subsequent development of carcinoma. Our objective is to analyze the management of B3 lesions in our center between 2017 and 2021 and compare it with the recommendations of the international consensus. Material and methods: Retrospective descriptive analysis. All patients with a histological diagnóstico (by BAG or AVB) of a B3 breast lesion, operated on or not, in the indicated period, were included in the study. Results: 79 cases were identified. BAG was performed in 83.54% of the cases and BAV in 16.45%. 80.3% of the BAG performed were diagnostic of LP, HDA in 6 cases and TF in 5 cases. BAV was performed in 11 cases. Surgical intervention was indicated in 97.46% of the cases. The anatomopathological analysis of the surgical specimen showed LP without atypia in 63.63% of the cases. Five cases (6.49%) were diagnosed with LCIS, five cases with DCIS, four cases with benign TF, and four cases with HDA. Two cases were diagnosed with CR and usual HD. Discussion: The management of B3 lesions carried out in our center is marked by overtreatment with respect to the consensus recommendations. A stricter adaptation to the current recommendations, the discussion of the cases in the CMD, which includes the radiopathological correlation and the evaluation of the residual lesion, and the more frequent use of AVB could reduce this tendency. (AU)
Asunto(s)
Humanos , Femenino , Mama/lesiones , Neoplasias de la Mama , Epidemiología Descriptiva , Estudios Retrospectivos , BiopsiaRESUMEN
La hidatidosis mamaria es una rara entidad, siendo excepcional su foco primario en la mama. Presentamos el caso de una mujer con una tumoración dolorosa palpable en la mama, con hallazgo de numerosos quistes en el estudio mastológico catalogados como BIRADS 3. Se realizó punción aspiración con aguja fina para citología, no concordante con los hallazgos radiológicos. Ante la persistencia de los síntomas, se realizó una exéresis quirúrgica de la lesión, con hallazgos en la biopsia compatibles con una parasitosis. Una serología positiva para Echinococcus granulosus confirmó el diagnóstico de hidatidosis, por lo que se inició el tratamiento postoperatorio con albendazol. Su evolución fue favorable, sin signos de recidiva y asintomática. Aunque poco común y en ocasiones de presentación y hallazgos inespecíficos, el quiste hidatídico debe considerarse como un diagnóstico diferencial potencialmente serio al evaluar cualquier lesión nodular en la mama en las pacientes de áreas endémicas de esta enfermedad o con factores de riesgo. (AU)
Hydatid breast disease is a rare entity, its primary focus in the breast being exceptional. We present the case of a woman with a palpable painful tumor in the breast, with the finding of numerous cysts in a mastological study, classified as BIRADS 3. FNA was performed for cytology, not consistent with radiological findings. Given the persistence of symptoms, a surgical excision of the lesion was performed, with biopsy findings compatible with parasitosis. A positive serology for Echinococcus granulosus confirmed the diagnosis of hydatidosis, for which postoperative treatment with albendazole was started. Its evolution was favorable, without signs of recurrence and asymptomatic. Although uncommon and sometimes with nonspecific presentation and findings, hydatid cyst should be considered as a potentially serious differential diagnosis when evaluating any nodular lesion in the breast in patients from endemic areas of this disease or with risk factors. (AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Equinococosis/diagnóstico , Equinococosis/tratamiento farmacológico , Mama/lesiones , Diagnóstico Diferencial , Enfermedades ParasitariasAsunto(s)
Humanos , Femenino , Mama/lesiones , Neoplasias de la Mama/diagnóstico por imagen , MamografíaRESUMEN
Resumo Objetivo relatar a experiência de indução da lactação em nuligestas realizada por enfermeira consultora em aleitamento. Método relato de experiência. O processo de indução láctea foi realizado com três mulheres por motivo de gestação em útero de substituição e relacionamento homoafetivo. Resultados todas perceberam o aumento de tamanho e a sensibilidade nas mamas, bem como apresentaram secreção láctea. No entanto, a continuidade da amamentação foi diferenciada entre elas. A primeira não recebeu apoio de profissionais de saúde no contexto de pós-parto hospitalar, nem em casa, e não deu continuidade à amamentação. A segunda recebeu apoio da equipe do hospital e da parceira, amamentando por três meses. A terceira, com o apoio da parceira, amamentou por dois meses, mas interrompeu por sentir-se inibida por familiares. Conclusão e implicações para a prática a técnica de indução é capaz de desencadear a produção láctea. Já o processo de amamentação só se estabeleceu mediante a associação com a rede de apoio, o acolhimento, o incentivo da equipe de saúde e o olhar integral à mulher e sua família. Dessa forma, o cuidado de Enfermagem na indução láctea não deve focar apenas no manejo da indução, mas transcender o aspecto técnico, o que se mostra como fundamental para a proteção, o estabelecimento e a continuidade da amamentação.
Resumen Objetivo reportar la experiencia de inducir la lactancia en nuligestas realizada por una consultora de enfermería en lactancia materna. Método relato de experiencia. El proceso de inducción de la leche se realizó con tres mujeres por embarazo en útero de reemplazo y relación homoafectiva. Resultados todas notaron el aumento de tamaño y la sensibilidad en las mamas, además de presentar secreción de leche. Sin embargo, la continuidad de la lactancia materna se diferencia entre ellos. La primera no recibió apoyo de los profesionales de la salud en el contexto posparto hospitalario, ni en el domicilio, y no continuó con la lactancia. La segunda recibió apoyo del personal del hospital y su pareja, amamantando durante tres meses. La tercera, con el apoyo de su pareja, amamantó durante dos meses, pero la interrumpió porque se sentía inhibida por familiares. Conclusión e implicaciones para la práctica la técnica de inducción es capaz de desencadenar la producción de leche. El proceso de lactancia materna, en cambio, solo se estableció a través de la asociación con la red de apoyo, la acogida, el estímulo del equipo de salud y la mirada integral a la mujer y su familia. Así, el cuidado de Enfermería en la inducción de la leche no debe enfocarse solo en el manejo de la inducción, sino trascender el aspecto técnico, que se muestra fundamental para la protección, el establecimiento y la continuidad de la lactancia materna.
Abstract Objective to report the experience of lactation induction in women who never got pregnant by a lactation consultant nurse. Method experience report. The process of lactation induction was performed with three women due to surrogate pregnancy and homosexual relationships. Results all noticed an increase in the size and sensitivity of the breasts, as well as milk secretion. However, the continuity of breastfeeding was different between them. The first did not receive support from health professionals in the postpartum hospital setting, nor at home, and did not continue breastfeeding. The second received support from the hospital staff and her partner, breastfeeding for three months. The third, with the support of her partner, breastfed for two months, but stopped because she felt inhibited by family members. Conclusion and implications for practice the induction technique is capable of triggering milk production. However, the breastfeeding process was only established through the association with the support network, the reception, the encouragement of the health team, and the comprehensive view of the woman and her family. Thus, nursing care in lactation induction should not focus only on the management of induction, but transcend the technical aspect, which is essential for the protection, establishment, and continuity of breastfeeding.
Asunto(s)
Humanos , Femenino , Lactancia Materna/métodos , Lactancia , Apoyo Social , Destete , Derechos de la Mujer , Mama/lesiones , Lactancia/efectos de los fármacos , Madres Sustitutas , Consultores , Domperidona/uso terapéutico , Acogimiento , Galactogogos/uso terapéutico , Informe de Investigación , Extracción de Leche Materna , Minorías Sexuales y de Género , Enfermeras ObstetricesRESUMEN
⺠History of bullying ⺠Lack of social support ⺠Multiple linear scars on breasts.
Asunto(s)
Mama/lesiones , Acoso Escolar , Conducta Autodestructiva/psicología , Conducta Autodestructiva/terapia , Apoyo Social , Traumatismos de los Tejidos Blandos , Adolescente , Terapia Cognitivo-Conductual , Femenino , Humanos , Factores de RiesgoRESUMEN
Pneumothorax resulting from traumatic thoracic injury is a potentially life-threatening emergency requiring prompt recognition and management with an intercostal drain. A 34-year-old woman was brought into the emergency department after sustaining a stab injury to the right upper outer quadrant of the right breast. She described noticing a jelly-like substance from her wound, on the background of a prior cosmetic breast augmentation. On examination, it was noted that the right breast was significantly swollen. Computed tomography demonstrated a large right sided pneumothorax with associated punctured right breast implant, a 'pneumocapsule' and extensive subcutaneous emphysema of the breast. This case highlights that the fibrous tissue capsule around a breast implant can function as an anatomical space in continuity with the thoracic cavity, masking the diagnosis of pneumothorax in penetrating trauma.
Asunto(s)
Implantes de Mama , Neumotórax/diagnóstico por imagen , Traumatismos Torácicos/diagnóstico por imagen , Heridas Punzantes/diagnóstico por imagen , Adulto , Mama/diagnóstico por imagen , Mama/lesiones , Tubos Torácicos , Femenino , Humanos , Laceraciones , Hígado/diagnóstico por imagen , Hígado/lesiones , Neumotórax/etiología , Neumotórax/terapia , Enfisema Subcutáneo , Traumatismos Torácicos/complicaciones , Toracostomía , Tomografía Computarizada por Rayos X , Heridas Punzantes/complicacionesRESUMEN
ABSTRACT: This article reviews the most up-to-date evidence-based recommendations pertaining to breast and upper chest conditions, specifically for the sports medicine physician. Because of the unique circumstances of the team physician, they can see a wide breadth of pathology. Athletes may not have a primary care physician and may prefer to present to their team physician for breast and upper chest conditions. It is often more comfortable and convenient for athletes to seek treatment in the team setting. Therefore, it is important that the medical professional be aware of not only common pathology but also of that which is rarer. Any delay in evaluation can result in unnecessary morbidity and lead to complications or extended time lost from sport. Consequently, it also is important to facilitate an atmosphere encouraging early presentation and workup.
Asunto(s)
Traumatismos en Atletas , Mama/lesiones , Traumatismos Torácicos , Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/etiología , Traumatismos en Atletas/terapia , Mama/anatomía & histología , Femenino , Ginecomastia/diagnóstico , Ginecomastia/epidemiología , Ginecomastia/etiología , Ginecomastia/terapia , Humanos , Masculino , Dolor/diagnóstico , Dolor/epidemiología , Dolor/etiología , Manejo del Dolor , Volver al Deporte , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/epidemiología , Traumatismos Torácicos/etiología , Traumatismos Torácicos/terapia , Tórax/anatomía & histologíaAsunto(s)
Humanos , Femenino , Mama/lesiones , Mama/patología , Personas Transgénero , Implantes de MamaAsunto(s)
Humanos , Modalidades de Fisioterapia , Resúmenes , Fisioterapeutas , Arteriosclerosis , Asma/epidemiología , Sueño , Mordeduras de Serpientes , Tabaquismo , Úlcera/terapia , Terapia por Ultrasonido , Perfil de Salud , Donantes de Sangre , Neoplasias Óseas/epidemiología , Mama/lesiones , Ejercicio Físico , Enfermedades de Transmisión Sexual/sangre , Fibromialgia , Infecciones por VIH , Prolapso Uterino/mortalidad , Toxoplasmosis Cerebral , Enfermedades Musculoesqueléticas , Fracturas Conminutas/terapia , Accidente Cerebrovascular/epidemiología , Espolón Calcáneo , Regeneración Tisular Dirigida , Diabetes Mellitus/epidemiología , Sepsis Neonatal , Celulitis , COVID-19 , COVID-19/complicaciones , ObesidadRESUMEN
Female-specific traumatic injury patterns have not been well researched and are potentially not well documented. Our aim was to examine the prevalence of breast hematomas (BHs) after blunt chest trauma, and to evaluate if there were risk factors associated with BH requiring intervention. A retrospective review from 2013 to 2018 was performed, identifying female patients ≥18 years sustaining blunt chest trauma. BH was defined as the presence of a collection of blood within the breast parenchyma, and clinically significant breast hematoma (CSBH) as BH requiring blood transfusion, surgical, or interventional radiology intervention. Univariate analysis was performed comparing CSBH with BH in terms of demographics, injury severity, antithrombotic agent use, and body mass index (BMI). Of 871 female patients meeting criteria, 59 (7%) had BH. Of these, 10 (17%) had CSBH (transfusion only, n = 3; angioembolization, n = 4; operation, n = 3). Compared to BH not requiring intervention, CSBH patients were older (mean age, 80 vs 69, P = .006), but had similar rates of motor vehicle crashes (90% vs 78%), seatbelt use (70% vs 71%), antiplatelet use (10% vs 12%), and anticoagulant use (10% vs 6%). Median Injury Severity Scores and median BMI (34 vs 34) were similar between the groups.
Asunto(s)
Enfermedades de la Mama/epidemiología , Mama/lesiones , Hematoma/epidemiología , Heridas no Penetrantes/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de la Mama/diagnóstico , Enfermedades de la Mama/terapia , Femenino , Hematoma/diagnóstico , Hematoma/terapia , Humanos , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Heridas no Penetrantes/diagnóstico , Heridas no Penetrantes/terapiaRESUMEN
Presentamos el caso de una paciente mujer de 34 años de edad que presentó ruptura de ligamento de Cooper de la mama izquierda a raíz de movimiento brusco de torsión de tronco. Dicha patología es poco frecuente y es importante considerarla en los posibles diagnósticos diferenciales de una lesión pectoral. En la literatura no se encuentran casos reportados, pero debido al aumento de la participación de la mujer en el deporte consideramos importante tenerlo presente en pacientes que presenten dolor súbito de la pared costal anterior
We report a 34 years-old woman who presented a Cooper's ligament tear after sudden chest torsion. This condition is extremely rare (to our knowledge, this is the first report published in the literature) but its inclusion in the differential diagnosis of traumatic chest conditions must be considered, especially since the woman is increasing the participation in sport in the last decade
Apresentamos o caso de uma paciente mulher de 34 anos de idade que apresentou uma rotura do ligamento de Cooper da mama esquerda devido a um movimento brusco de torção do tronco. Esta patología é pouco frequente e é importante considerá-la nos possiveis diagnósticos diferenciais de uma lesão peitoral. Na literatura no se encontram casos reportados mas devido ao aumento da participação da mulher no desporto consideramos importante tê-lo presente em pacientes que apresentem uma dor súbita da parede costal anterior
Asunto(s)
Humanos , Femenino , Adulto , Ligamentos/lesiones , Mama/lesiones , Enfermedades de la Mama/diagnóstico por imagen , Traumatismos en Atletas/diagnóstico por imagen , Levantamiento de Peso/lesiones , Diagnóstico Diferencial , Espectroscopía de Resonancia Magnética/métodosAsunto(s)
Neoplasias de la Mama/radioterapia , Mama/lesiones , Contusiones/diagnóstico , Hemangiosarcoma/diagnóstico , Neoplasias Inducidas por Radiación/diagnóstico , Mama/irrigación sanguínea , Contusiones/etiología , Diagnóstico Diferencial , Femenino , Hemangiosarcoma/etiología , Humanos , Persona de Mediana EdadRESUMEN
OBJECTIVES: Female contact football players sustain contact breast injuries that can negatively affect their sporting performance. This study investigated what female contact football players wear on their breasts during training and competition, and their perceptions on the protection provided by these garments against contact breast injury. DESIGN: A custom-designed survey about breast injuries and prevention strategies was distributed via an online link to coaches and team staff of contact football teams throughout Australia. The fit and features of breast support and/or protection that players wore during training and competition were also directly assessed. METHODS: 207 female Australian Football League (AFL), Rugby League, Rugby Union (XVs) and Rugby 7s players completed the survey. The breast support of 112 of these players was also assessed. RESULTS: Only 17% (n=35) of players reported using breast protective equipment, of which 66% (n=23) perceived it provided protection against contact breast injuries. Reasons reported for not using protective equipment included not knowing it existed (n=79, 53%), it was too uncomfortable/hot (n=50, 24%) and that it did not fit or was restrictive (n=33, 22%). Although most players (n=97, 87%) reported to wear a sports bra, 52% (n=58) wore an ill-fitted bra and only 31% (n=63) perceived it provided any protection against contact breast injuries. CONCLUSIONS: Breast protective equipment is not commonly worn by female contact football players reportedly due to a lack of awareness of its existence, discomfort or poor fit. Although most female contact football players usually wore a sports bra, most players perceived these bras did not provide breast protection.
Asunto(s)
Traumatismos en Atletas , Mama , Ropa de Protección , Equipos de Seguridad , Rugby , Deportes , Adulto , Femenino , Humanos , Adulto Joven , Traumatismos en Atletas/prevención & control , Australia , Mama/lesiones , Rugby/lesiones , Encuestas y CuestionariosRESUMEN
Seat belt-related female breast trauma (SFBT) is an uncommon cause of haemorrhage following motor vehicle collision. Classification systems have been used to grade the severity of SFBT, ranging from mild class I to severe class IV injuries with evidence of active haemorrhage. In the case of class IV injuries, contrast extravasation represents active haemorrhage, prompting angiographic embolisation or surgery to arrest the bleed. Contrary to the majority of reports published in the literature, our institution has been successful with conservative management of class IV SFBT. None of the patients required specific intervention to control haemorrhage from SFBT.
Asunto(s)
Mama/lesiones , Tratamiento Conservador/métodos , Extravasación de Materiales Terapéuticos y Diagnósticos/diagnóstico por imagen , Hemorragia/terapia , Cinturones de Seguridad/efectos adversos , Tomografía Computarizada por Rayos X/métodos , Accidentes de Tránsito , Anciano , Anciano de 80 o más Años , Mama/diagnóstico por imagen , Femenino , Hemorragia/diagnóstico por imagen , Hemorragia/etiología , Humanos , Persona de Mediana Edad , Centros Traumatológicos , Resultado del TratamientoRESUMEN
The breast and anterior chest are the most commonly burned part of the trunk. Burn injuries to the breast can be associated with pain, asymmetries, and significant social stigma. Burns to the breast bud in the young female may inhibit normal breast development and result in either significant asymmetries or amastia, making the treatment of breast burn injuries challenging. A retrospective chart review was conducted on all female patients under the age of 21 years admitted to our institution for breast burn injuries from January 1, 2008 to December 30, 2018. Patients were included if they had follow-up reconstructive procedures for breast burn injuries many days after their acute-phase treatment. Ninety-six patients aged 1 to 20 years have been admitted to our institution with burned breast injuries. The mean age of this cohort (n = 96) was 6.4 ± 4.8 years with a mean percent TBSA of 36.3 ± 21.4 and a mean time since injury from admission of 2279.1 ± 2284.1 days. Flame burns (66.8 percent) were the most common etiology for breast burn injuries, followed by scald burns (22.8 percent), in this cohort. The mean body mass index was 22.7 ± 6.3 kg/m2. Follow-up for reconstructive procedures was 7.2 ± 5.6 years after injury date. Our institution's 10-year experience of 96 female patients with severe burn injuries has enhanced our understanding of reconstructive techniques. The location, size, anatomic extent, type of deformity, and symmetry must all be assessed before any treatment plans, which may need to include a combination of modalities.
Asunto(s)
Mama/lesiones , Mama/cirugía , Quemaduras/cirugía , Mamoplastia/métodos , Traumatismos Torácicos/cirugía , Adolescente , Superficie Corporal , Niño , Preescolar , Femenino , Humanos , Lactante , Estudios Retrospectivos , Adulto JovenAsunto(s)
Mama/lesiones , Violencia , Adolescente , África Occidental/etnología , Mama/crecimiento & desarrollo , Niño , Femenino , Humanos , Reino Unido , Violencia/etnologíaRESUMEN
Necrotising fasciitis is a rare infection of the skin and underlying soft tissue. It primarily involves the extremities and rarely the breast. Primary necrotising fasciitis of the breast in a non-lactating, healthy female is rarer still. The authors present the case report of a patient presenting with primary necrotising fasciitis of the breast after sustaining a penetrating injury. The patient was managed successfully with serial debridement and negative pressure wound therapy (NPWT). To our knowledge only 19 such cases have been reported in the indexed literature so far. This is also the eighth case globally of primary necrotising fasciitis of the breast in a non-lactating female without any associated immunosuppression, which is the basis of reporting this case.
Asunto(s)
Enfermedades de la Mama/etiología , Enfermedades de la Mama/cirugía , Mama/lesiones , Fascitis Necrotizante/etiología , Fascitis Necrotizante/terapia , Heridas Penetrantes/complicaciones , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Enfermedades de la Mama/microbiología , Terapia Combinada , Desbridamiento , Fascitis Necrotizante/microbiología , Femenino , Humanos , Terapia de Presión Negativa para HeridasRESUMEN
Introdução: Ao longo dos últimos anos os benefícios das reconstruções imediatas se tornaram cada vez mais documentados na literatura e, hoje, o predomínio é pelas reconstruções imediatas. Nos últimos anos, o número de reconstruções com expansores e próteses tem aumentado. Métodos: Estudo retrospectivo entre 2013 e 2014. Foram incluídas as pacientes submetidas à mastectomia, seguida de reconstrução de mama, e assim separadas em dois grupos: 1 - submetida a reconstrução direta com prótese e 2 - expansor. Diversos dados foram avaliados. Resultados: Foram realizadas 138 reconstruções assim divididos: 57 com prótese e 81 com expansor-prótese. As complicações pós-operatórias não mostraram diferença entre os grupos. Radioterapia não teve influência nas complicações. Pacientes que fizeram reconstrução com prótese realizaram menos cirurgias (1,78 vs 2,54) e menos retornos pós-operatórios (8 vs 11,75). Conclusão: As reconstruções imediatas com prótese ou expansor apresentam baixas e semelhantes taxas de complicações pós-operatórias. Pacientes submetidas às reconstruções com prótese tiveram menor taxa de retorno e número de cirurgias para finalizar a reconstrução.
Introduction: The benefits of immediate reconstruction have been increasingly documented in the literature over the past few years. Today, with some exceptions, immediate reconstruction is the preferred surgical choice for breast cancer patients. In the recent years, the number of reconstructions using expanders and implants has increased. Methods: This retrospective study conducted between 2013 and 2014 included patients undergoing mastectomy followed by breast reconstruction, who were divided into direct implant reconstruction and expander treatment groups. Several variables were evaluated. Results: A total of 138 reconstructions (57 implants and 81 expander-implant) were performed. There were no intergroup differences in postoperative complications. Radiotherapy did not influence complications. Implant reconstruction patients underwent fewer surgeries (1.78 vs 2.54) and had fewer postoperative returns (8 vs 11.75). Conclusion: Immediate implant and expander-implant reconstruction approaches present low and similar postoperative complication rates. Patients undergoing implant reconstruction had a lower return rate and underwent fewer surgeries than those undergoing expander-implant reconstruction.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Historia del Siglo XXI , Complicaciones Posoperatorias , Mama , Estudios Retrospectivos , Mamoplastia , Implantes de Mama , Procedimientos de Cirugía Plástica , Complicaciones Posoperatorias/cirugía , Mama/cirugía , Mama/lesiones , Mamoplastia/métodos , Implantes de Mama/efectos adversos , Procedimientos de Cirugía Plástica/métodosRESUMEN
Introducción: La mastitis granulomatosa es una entidad benigna poco frecuente en la que no existe consenso sobre el tratamiento más adecuado. El objetivo fue analizar las características de esta enfermedad y su manejo en nuestra experiencia y compararlo con los antecedentes descritos en la literatura. Material y métodos: Se realizó un estudio descriptivo retrospectivo de los pacientes diagnosticados de mastitis granulomatosa en nuestro centro entre 2013 y 2018. Resultados: De las 4 mujeres con diagnóstico histológico de mastitis granulomatosa, ninguna presentaba historia de reciente embarazo, lactancia ni tratamiento anticonceptivo. Como factores de riesgo solo se identificó el hábito tabáquico en una paciente y un antecedente traumático en otra. La clínica de presentación más frecuente fue la de tumoración palpable unilateral. Como exploraciones complementarias se realizaron mamografía/tomosíntesis y ecografía en todos los casos y el diagnóstico se estableció tras el estudio histológico de una biopsia con aguja gruesa. Respecto al tratamiento, en 2 casos fue observacional y en otros 2 médico; hubo una sola complicación en forma de absceso mamario. Conclusiones: Para instaurar el diagnóstico definitivo de mastitis granulomatosa y descartar el cáncer de mama es necesario el estudio histológico, debido a la poca especificidad de otras pruebas
Introduction: Granulomatous mastitis is a rare breast disease. There is no consensus on the optimal treatment. The aim of this study was to analyse the characteristics of this disease and its management in our centre and to compare the findings with those reported in the literature. Material and methods: We conducted a descriptive retrospective study of patients with a diagnosis of granulomatous mastitis in our centre between 2013 and 2018. Results: None of the 4 women with a histological diagnosis of granulomatous mastitis had a recent history of pregnancy, lactation, or contraceptive treatment. One patient was a smoker and another had a history of trauma. The most common symptom was a unilateral palpable mass. Mammography/tomosynthesis and ultrasonography were performed in all patients and the definitive diagnosis was based on histological analysis after core needle biopsy. Two patients received no treatment (only observation) and the other 2 received medical treatment. There was only one complication (breast abscess). Conclusions: To establish a definitive diagnosis of granulomatous mastitis and to rule out breast cancer, histological study is necessary due to the low specificity of other tests