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PURPOSE: The aim of this study is to describe our initial experience using magnetic seeds (Magseed®) to guide breast-conserving surgery in non-palpable breast lesions and compare the use of magnetic seed with wires to guide breast-conserving surgery in terms of clinical and pathological characteristics. METHODS: We performed a retrospective study including all breast-conserving surgeries for non-palpable breast lesions under 16 mm from June 2018 to May 2021. We compared breast-conserving surgeries guided with magnetic seeds (Magseed®) to those guided with wires, analyzing tumor and patient characteristics, surgical time, and pathological results of the surgical specimens. RESULTS: Data from 225 cases were collected, including 149 cases guided by magnetic seeds and 76 cases guided by wires. The breast lesion was localized in every case. Both cohorts were similar regarding clinical and pathological characteristics. We found significant statistical differences (p < 0.02) in terms of the median volume (cm3) of the excised specimen, which was lower (29.3%) in the magnetic seed group compared with the wire group (32.5 [20.5-60.0]/46.0 [20.3-118.7]). We did not find significant differences regarding surgical time (min) or the affected or close margins. CONCLUSION: In our experience, the use of magnetic seed (Magseed®) is a feasible option to guide breast-conserving surgery of non-palpable lesions and enabled us to resect less breast tissue.
ABSTRACT
OBJETIVO: Establecer el estado actual del empleo de hormonoterapia en neoadyuvancia (HTNA) en las distintas unidades de patología mamaria del territorio nacional. MATERIAL Y MÉTODOS: Se confeccionó una encuesta electrónica de 14 preguntas que se envió a los socios de la Sociedad Española de Senología y Patología Mamaria (SESPM) así como a miembros de otros centros del ámbito público y privado. RESULTADOS: Se obtuvieron 79 respuestas. El 74,7% correspondían a centros del ámbito público. El 77,2% afirman emplear HTNA, si bien la mayoría (44,3%) solo en caso de mujeres ancianas pluripatológicas. El seguimiento de las pacientes corre a cargo del oncólogo médico en el 62,0% de los casos, siendo la exploración (64,7%), la resonancia (55,9%) y la ecografía los métodos más empleados en el seguimiento. El fármaco más utilizado es el letrozol (45,5%) y la duración habitual del tratamiento es de 3-6meses en casi de la mitad de los casos (43,0%). El 82,2% de los encuestados afirman realizar HTNA en caso de axila positiva, si bien casi la mitad (47,6%) la restringen al caso de mujer anciana con comorbilidad. La alternativa en caso de no respuesta es la cirugía en el 78,5% de los casos. El 72,2% de los encuestados creen que la posibilidad de realizar una plataforma genómica en la biopsia inicial les animaría a emplear más la HTNA. CONCLUSIONES: La HTNA es un método empleado por las unidades de mama de forma habitual, si bien su uso queda relegado por lo general a mujeres ancianas con comorbilidades
OBJECTIVES: To establish the current state of the use of neoadjuvant endocrine treatment (NET) for breast cancer in breast cancer units (BCU) in Spain. MATERIAL AND METHODS: A 14-question electronic survey was designed and sent on-line to members of the Spanish Society of Senology and Breast Disease (SESPM) as well as to other breast cancer units in public and private healthcare centres in Spain. RESULTS: A total of 79 surveys were completed. Nearly three quarters (74.7%) of respondents worked in public centres, and 77.2% used NET, although most (44.3%) only used it in elderly or frail women. Follow-up was carried out by a medical oncologist in 62.0% of the cases. The preferred follow-up methods were clinical examination (64.7%), MRI (55.9%) and ultrasound (48.5%). Letrozole was the chosen drug in 45.5%, and 43.0% maintained treatment for 3-6months. Most (82.2%) respondents used NET when there were axillary-positive nodes but, of these, 47.6% restricted it to frail elderly women. Surgery was the alternative treatment in 78.5% of non-responders. In all, 72.2% of the respondents believed that the possibility of performing a genomic profile in the core biopsy would increase the chances of NET use. CONCLUSIONS: NET is a frequently employed method in BCUs in Spain, although its use is usually relegated to elderly or frail women
Subject(s)
Humans , Female , Antineoplastic Agents, Hormonal/administration & dosage , Neoadjuvant Therapy , Breast Neoplasms/drug therapy , Practice Patterns, Physicians' , Health Care Surveys , SpainABSTRACT
BACKGROUND: Pelvic exenteration is an ultraradical surgery involving the en bloc resection of the pelvic organs, including the internal reproductive organs, the distal urinary tract (ureters, bladder, urethra), and/or anorectum. It is mainly applied as a salvage surgery for recurrent gynecologic tumors of any origin (vulva, vagina, cervix, uterine, and also ovary). Our aim was to establish the most favorable cases for this type of surgery by means of a review of our institution experience. METHODS: Retrospective analyses of all patients treated with pelvic exenteration for recurrent gynecologic cancer from 2008 to 2014 at La Paz University Hospital. RESULTS: Ten patients underwent pelvic exenteration for recurrent gynecologic cancers including uterine, cervical, vaginal, vulvar, and ovarian cancer. All patients had received prior treatment: surgery, radiotherapy, and/or chemotherapy. Eight patients underwent total pelvic exenteration, one anterior and one posterior pelvic exenteration. Urinary diversions technique consisted of ileal conduits in all cases. Permanent colostomy was performed in all cases. Postoperative complications were related to the urinary diversion in 50% of the cases, to the reconstructive technique in 30%, and to systemic or pelvic infections in 20%. CONCLUSIONS: Despite the high morbidity and mortality rates, pelvic exenteration is feasible, and in selected cases of cancer recurrence is the last possible treatment.