Cavity shaving for invasive breast cancer conservative surgery: Reduced specimen volume and margin positive rates.

INTRODUCTION: The cavity shaving (CS) technique was described in breast conserving surgery to reduce the rate of reoperation avoiding the need for intraoperative margin analysis. This study assesses differences in the rates of involvement of the surgical margin (requiring further surgery) and volume of surgical specimens, depending on the use or not of this technique. MATERIAL AND METHODS: A retrospective cohort study was conducted in patients with breast carcinoma who underwent breast conserving surgery between 2013 and 2019. They were divided into two groups depending on whether the cavity shaving technique was used or not. Primary outcomes of the study included presence of final margin involvement, requiring need for further surgery, and the volume of excised tissue comparing the study groups. RESULTS: A total of 202 cases were included: 92 in the control group and 110 in the cavity shaving group. Significant differences were found regarding involvement of the final margin (19.57% control group vs. 4.55% cavity shaving group; p = 0.010). The volume of additional surgical specimens were significantly greater in the traditional technique group than in the shaving technique (46.43 vs 13.32 cm3; p = 0.01) as was total specimen volume (143.40 vs 100.63 cm3; p = 0.022). CONCLUSIONS: CS can reduce the positive margin and re-excision rates without larger-volume resections and should therefore be considered a routine technique in BCS for early-stage breast cancer.

Is the result of breast Tc-99m mibi scintigraphy a prognostic factor for survival in invasive breast cancer? / ¿Es el resultado de la gammagrafía con Tc-99m MIBI un factor pronóstico para la supervivencia en el cáncer invasor de mama?

Background Breast scintigraphy with Tc-99m MIBI showed utility in diagnosing and monitoring response to neoadjuvant treatment. This work studies if there are differences in long-term survival in breast carcinomas depending on the result of Tc-99 MIBI scintigraphy and to analyze their relationship with other variables of prognostic value. Material and methods A prospective observational study on a series of cases of breast cancer in which scintigraphy with Tc-99m MIBI was carried out prior to its treatment, and which had a minimum follow-up of ten years. Clinical–epidemiological, histopathological and immunohistochemical variables were recorded. Bivariate and multivariate analysis were performed studying the result of Tc99m-MIBI scintigraphy. Differences in OS and DFS were studied using Kaplan Meier curves with the log-rank test between factors. Results The significant relationship was found between Tc-99m-MIBI positive result and palpable tumors (p=0.0001), poorly differentiated (p=0.003), with lymph node involvement (p=0.038) and high cell proliferation (p=0.007), although only the palpability and tumor size are related after multivariate analysis. Patients with Tc-99m MIBI positive tumors showed a worse OS (p=0.043) and DFS (p=0.026), independently of size and palpability of the lesión. Conclusion Tc-99m MIBI scintigraphy showed prognostic importance in invasive breast cancer, relating its positivity to reduced long-term survival. (AU)

Introducción La gammagrafía mamaria con Tc-99m MIBI ha mostrado su utilidad en el diagnóstico y la monitorización de la respuesta al tratamiento neoadyuvante. Este trabajo estudia si hay diferencias en la supervivencia por cáncer de mama a largo plazo dependiendo del resultado de la gammagrafía con Tc-99m MIBI y analizar su relación con otras variables de valor pronóstico. Material y métodos Se realizó un estudio observacional prospectivo sobre una serie de pacientes con cáncer de mama en las que se realizó una gammagrafía con Tc-99m MIBI previa a su tratamiento, y con un seguimiento mínimo de 10 años. Se registraron variables clínico-epidemiológicas, histopatológicas e inmunohistoquímicas. Se realizaron análisis bivariante y multivariante para el resultado de la gammagrafía con Tc-99m MIBI. Se estudiaron la supervivencia glogal y libre de enfermedad mediante la curva de Kaplan-Meier y el test de log-rank entre factores. Resultados Se encontró una relación significativa entre la gammagrafía con Tc-99m MIBI positiva y las lesiones palpables (p=0,0001), pobremente diferenciadas (p=0,003), con afectación ganglionar (p=0,038) y alta proliferación celular (p=0,007), aunque solo la palpabilidad y el tamaño tumoral fueron significativos en el análisis multivariante. Las pacientes con gammagrafía positiva mostraron peor supervivencia global (p=0,043) y libre de enfermedad (p=0,026), independientemente del tamaño o la palpabilidad de la lesión. Conclusión La gammagrafía mamaria con Tc-99m MIBI presenta una relevancia pronóstica en cáncer invasor de mama, relacionando su positividad con menor supervivencia a largo plazo. (AU)

Pólipo fibroepitelial estromal vulvo-vaginal y de cérvix / Vulvovaginal and cervical fibroepithelial polyps: clinico-pathological features of a series of 22 cases

El pólipo fibroepitelial estromal es una entidad benigna, cuya peculiaridad más importante es la variedad de hallazgos histopatológicos que puede presentar, y que todavía frecuentemente se diagnostica erróneamente como maligno, a pesar de que es una entidad bastante bien estudiada en la literatura. Hemos recogido nuestra casuística en los últimos 5 años y revisado la literatura (AU)