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1.
Pol Przegl Chir ; 95(6): 20-23, 2023 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38058164

RESUMO

<b>Introduction:</b> Following the Russian invasion, more than 3600000 refugees have fled Ukraine and settled down in Poland; this group includes a growing number of breast cancer patients whose treatment had been started in Ukraine and hence required urgent therapy in Poland.</br></br> <b>Aim:</b> The aim of the study was to analyze the treatment of breast cancer patients from Ukraine, who entered Poland as war refugees - the experience of a single tertiary care institution.</br></br> <b>Material and methods:</b> The treatment of 25 consecutive breast cancer patients, war refugees from Ukraine was reviewed retrospectively.</br></br> <b>Results:</b> Patients were treated according to subtype and staging, e.g. surgery, endocrine, anti-HER2 therapy, chemotherapy, radiotherapy. 7 patients received an immediate implant, mesh-based breast reconstruction. In 2 cases, the patients refused breast reconstruction.</br></br> <b>Conclusions:</b> Nearly 5.5 million refugees across Europe who have fled the combat zones in Ukraine; of these, the vast majority sought shelter in Poland, and many of whom are women. It is expected that breast cancer mortality rates may rise and progress in oncology may slow as the war in Ukraine disrupts routine patient care, clinical trials and research. Hence, support from neighboring countries is mandatory.


Assuntos
Neoplasias da Mama , Mamoplastia , Refugiados , Humanos , Feminino , Masculino , Polônia , Neoplasias da Mama/cirurgia , Estudos Retrospectivos , Ucrânia , Atenção Terciária à Saúde
2.
Arch Med Sci ; 19(5): 1243-1251, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37732037

RESUMO

Introduction: Although breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is infrequent, with less than 1000 noted cases worldwide, patients consenting for breast implant surgery should be aware of its risk. We describe the first Polish multicenter case-series data on BIA-ALCL patients and present diagnostic and treatment recommendation for breast surgeons. Material and methods: In cooperation with the Polish Society of Surgical Oncology and Polish Lymphoma Research Group, we collected BIA-ALCL cases in Poland. Results: We retrospectively reviewed clinical data of seven BIA-ALCL patients, diagnosed between July 2013 and November 2019. The median time from implant placement to the first BIA-ALCL symptoms was 65 months (range: 33-96 months). All the patients were exposed to textured implants at presentation. Capsulectomy with implant removal was performed in all the patients with immediate reimplantation in 2 cases. In a median follow-up of 19 months (range 5-81 months), there was no recurrence and all the patients stayed alive. Between 2013 and 2019, the incidence of BIA-ALCL in Polish female population age 30 and above ranged from 0 to 0.021/100 000/year. Conclusions: BIA-ALCL is scarce in the Polish population. In a short-term follow-up, patients' prognosis remains excellent. Due to the withdrawal of roughly textured implants from the market and the exclusion of likely the most potent etiologic factor, it might be expected that the incidence of BIA-ALCL will become even rarer.

3.
Plast Reconstr Surg ; 151(6): 1123-1133, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-36728789

RESUMO

BACKGROUND: Breast cancer remains the most common nonskin cancer among women. Prophylactic methods for reducing surgical-site complications after immediate breast reconstruction (IBR) are crucial to prevent acellular dermal matrices or prosthesis exposure and loss. The authors assessed the impact of closed-incision negative-pressure wound therapy (ciNPWT) versus standard dressings (ST) after IBR on surgical-site complications, superficial skin temperature (SST), skin elasticity, and subjective scar quality, to determine the potential benefit of prophylactic ciNPWT application. METHODS: A multicenter randomized controlled study of 60 adult female patients was conducted between January of 2019 and July of 2021. All patients had oncologic indications for IBR using implants or expanders. RESULTS: Application of ciNPWT correlated with a significant decrease in surgical-site complications within 1 year of surgery (total, 40%; ST, 60%; ciNPWT, 20%; P = 0.003) and resulted in more elastic scar tissue as measured with a Cutometer (average coefficient of elasticity, 0.74; ST, 0.7; ciNPWT, 0.9; P < 0.001). The SST of each scar 1 week after surgery was significantly higher in the ciNPWT group (average SST, 31.5; ST SST, 31.2; ciNPWT SST, 32.3; P = 0.006). According to the Patient and Observer Scar Assessment Scale v2.0, subjective scar outcomes in both groups were comparable. CONCLUSIONS: This is the first randomized controlled study that demonstrated a significant decrease in surgical-site wound complications within 1 year of surgery in IBR patients receiving ciNPWT. A high probability of postoperative radiotherapy should be a relative indication for the use of ciNPWT. . CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Assuntos
Neoplasias da Mama , Mamoplastia , Tratamento de Ferimentos com Pressão Negativa , Ferida Cirúrgica , Adulto , Humanos , Feminino , Cicatriz/prevenção & controle , Cicatriz/complicações , Tratamento de Ferimentos com Pressão Negativa/métodos , Ferida Cirúrgica/terapia , Ferida Cirúrgica/complicações , Infecção da Ferida Cirúrgica/prevenção & controle , Mamoplastia/efeitos adversos , Mamoplastia/métodos , Neoplasias da Mama/cirurgia , Neoplasias da Mama/complicações
4.
Pol Przegl Chir ; 95(4): 1-5, 2023 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-36808061

RESUMO

INTRODUCTION: Correct surgical technique and perioperative care are two factors that can reduce the number of complications, improve treatment outcomes and shorten the length of hospital stay. The introduction of enhanced recovery protocols has changed the approach to patient care in some centers. However, there are significant differences among centers, and in some the standard of care has remained unchanged. AIM: the goal of the panel was to develop recommendations for modern perioperative care in accordance with current medical knowledge in order to reduce the number of complications associated with surgical treatment. An additional goal was to optimize and standardize perioperative care among Polish centers. MATERIALS AND METHODS: the development of these recommendations was based on a review of the available literature from the PubMed, Medline and Cochrane Library databases from January 1, 1985 to March 31, 2022, with particular emphasis on systematic reviews and clinical recommendations of recognized scientific societies. Recommendations were formulated in a directive form and were assessed using the Delphi method. RESULTS AND CONCLUSIONS: 34 recommendations for perioperative care were presented. They cover aspects of pre-, intra- and post-operative care. Implementation of the presented rules allows to improve the results of surgical treatment.


Assuntos
Procedimentos Cirúrgicos Eletivos , Assistência Perioperatória , Humanos , Consenso , Assistência Perioperatória/métodos , Complicações Pós-Operatórias , Tempo de Internação
5.
Cancers (Basel) ; 15(4)2023 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-36831516

RESUMO

BACKGROUND: Surgical excision of a non-palpable breast lesion requires a localization step. Among available techniques, wire-guided localization (WGL) is most commonly used. Other techniques (radioactive, magnetic, radar or radiofrequency-based, and intraoperative ultrasound) have been developed in the last two decades with the aim of improving outcomes and logistics. METHODS: We performed a systematic review on localization techniques for non-palpable breast cancer. RESULTS: For most techniques, oncological outcomes such as lesion identification and clear margin rate seem either comparable with or better than for WGL, but evidence is limited to small cohort studies for some of the devices. Intraoperative ultrasound is associated with significantly higher negative margin rates in meta-analyses of randomized clinical trials (RCTs). Radioactive techniques were studied in several RCTs and are non-inferior to WGL. Smaller studies show higher patient preference towards wire-free localization, but little is known about surgeons' and radiologists' attitudes towards these techniques. CONCLUSIONS: Large studies with an additional focus on patient, surgeon, and radiologist preference are necessary. This review aims to present the rationale for the MELODY (NCT05559411) study and to enable standardization of outcome measures for future studies.

6.
Pol Przegl Chir ; 94(4): 53-60, 2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-36047361

RESUMO

This document - "Polish Consensus on Gastric Cancer Diagnosis and Treatment - Update 2022" - represents an expert consensus following a year's worth of dedicated effort by a team of specialists throughout 2021, put forward in a conference in December 2021 in Krakow, and finalized below for publication in 2022. The effective date of this document is June 14th 2022. The work that went into updating this consensus was made under auspices of the Polish Society of Surgical Oncology and the Association of Polish Surgeons.


Assuntos
Neoplasias Gástricas , Consenso , Humanos , Polônia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/terapia
7.
Rev. cir. (Impr.) ; 74(4): 426-431, ago. 2022. ilus
Artigo em Espanhol | LILACS | ID: biblio-1407931

RESUMO

Resumen El verde de indocianina es un tinte que se ha utilizado en medicina durante varias décadas. Tiene una serie de aplicaciones, incluida la cirugía reconstructiva y las quemaduras. Permite detectar áreas de tejido con perfusión reducida, lo que reduce el riesgo de complicaciones posoperatorias en forma de procesos de cicatrización alterados y necrosis. La técnica de imágenes que utiliza este tinte, permite observar los cambios en la fluorescencia en tiempo real y que, se ha demostrado, ocurren entre las capas superficiales y profundas en las quemaduras. Esto permite un diagnóstico cualitativo y cuantitativo de la profundidad de la quemadura, lo que se traduce en la elección de un tratamiento adicional. Se aprecia la importancia particular de este método en la prevención de la necrosis cutánea con el complejo areola-pezón durante la reconstrucción mamaria simultánea. Se necesitan más ensayos controlados aleatorios prospectivos para considerarlo el "método de elección" en la práctica clínica.


Indocyanine green is a dye that has been used in medicine for several decades. It has a number of applications, including reconstructive surgery and burns. It allows the detection of areas of tissue with reduced perfusion, which reduces the risk of postoperative complications in the form of altered healing processes and necrosis. The imaging technique that uses this dye allows us to observe the changes in fluorescence in real time that have been shown to occur between the superficial and deep layers in burns. This allows a qualitative and quantitative diagnosis of the depth of the burn, which results in the choice of additional treatment. The particular importance of this method in the prevention of skin necrosis with the areolanipple complex is appreciate during simultaneous breast reconstruction. More prospective randomized controlled trials are needed to consider it the 'method of choice' in clinical practice.


Assuntos
Humanos , Queimaduras/diagnóstico , Corantes/uso terapêutico , Verde de Indocianina/uso terapêutico , Cicatrização , Fluorescência , Mastectomia
8.
Curr Issues Mol Biol ; 44(7): 3075-3088, 2022 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-35877436

RESUMO

The cellular response to hypoxia includes the expression of hypoxia-inducible factor-1 (HIF-1) and its target genes: vascular endothelial growth factor (VEGF) and CXC chemokine receptor 4 (CXCR4). The aim of this study was to investigate the expression and prognostic significance of VEGF and CXCR4, which are responsible for angiogenesis and progression in gastric cancer. Twenty-eight gastric cancer patients were analyzed. The mRNA expression was examined in primary tumors and corresponding normal gastric mucosa by RT-PCR. The protein level was examined by immunohistochemistry staining. The high expression of VEGF and CXCR4 was found in 71.0 and 64.0% of tumors, respectively. The mean levels of VEGF and CXCR4 were upregulated in primary tumors compared to normal mucosa (p = 0.0007, p = 0.0052). A correlation between VEGF expression and tumor invasion (p = 0.0216) and stage (p = 0.0181) was found. CXCR4 expression correlated with lymph node metastases (p = 0.0237) and stage (p = 0.0054). The VEGF expression correlated with microvessel density (MVD) (p = 0.0491). The overall 3-year survival rate was 46.4% and correlated negatively with high CXCR4 mRNA expression (p = 0.0089). VEGF and CXCR4 play an important role in tumor progression. Their overexpression correlates with a bad prognosis and may improve high-risk patient selection, and these patients may obtain additional survival benefits if treated more aggressively.

9.
Pathol Oncol Res ; 28: 1610377, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35783360

RESUMO

This text is based on the recommendations accepted by the 4th Hungarian Consensus Conference on Breast Cancer, modified on the basis of the international consultation and conference within the frames of the Central-Eastern European Academy of Oncology. The recommendations cover non-operative, intraoperative and postoperative diagnostics, determination of prognostic and predictive markers and the content of cytology and histology reports. Furthermore, they address some specific issues such as the current status of multigene molecular markers, the role of pathologists in clinical trials and prerequisites for their involvement, and some remarks about the future.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Hungria , Mastectomia , Oncologia , Prognóstico
10.
Cancers (Basel) ; 14(13)2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35804960

RESUMO

(1) Introduction: In response to patient concerns about breast cancer recurrence, increased use of breast magnetic resonance imaging and genetic testing, and advancements in breast reconstruction techniques, mastectomy rates have been observed to rise over the last decade. The aim of the study is to compare the outcomes of prepectoral and subpectoral implants and long-term, dual-stage resorbable mesh-based breast reconstructions in mutation carriers (prophylactic surgery) and breast cancer patients. (2) Patients and methods: This retrospective, two-center study included 170 consecutive patients after 232 procedures: Prepectoral surgery was performed in 156 cases and subpectoral was performed in 76. (3) Results: Preoperative chemotherapy was associated with more frequent minor late complications (p < 0.001), but not major ones (p = 0.101), while postoperative chemotherapy was related to more frequent serious (p = 0.005) postoperative complications. Postoperative radiotherapy was associated with a higher rate of minor complications (31.03%) than no-radiotherapy (12.21%; p < 0.001). Multivariate logistic regression found complications to be significantly associated with an expander (OR = 4.43), skin-reducing mastectomy (OR = 9.97), therapeutic mastectomy vs. risk-reducing mastectomy (OR = 4.08), and postoperative chemotherapy (OR = 12.89). Patients in whom prepectoral surgeries were performed demonstrated significantly shorter median hospitalization time (p < 0.001) and lower minor complication rates (5.77% vs. 26.32% p < 0.001), but similar major late complication rates (p = 0.915). (4) Conclusions: Implant-based breast reconstruction with the use of long-term, dual-stage resorbable, synthetic mesh is a safe and effective method of breast restoration, associated with low morbidity and good cosmesis. Nevertheless, prospective, multicenter, and long-term outcome data studies are needed to further evaluate the benefits of such treatments.

11.
Postepy Dermatol Alergol ; 39(1): 47-51, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35369633

RESUMO

Introduction: According to the Polish Central Statistical Office and the National Cancer Registry, cancer is the main cause of death in the world. Every year over 8 million people die from cancer worldwide, while in Poland the disease kills nearly 100,000 people. The group of patients analysed in this study suffered from breast, colorectal and lung cancers, and underwent radio- and chemotherapy. The patients were treated with a cosmetic formulation to accelerate the healing of their skin and improve the functioning of the hydrolipidic barrier. Aim: To examine oncological patients' skin and to improve its biophysical parameters with a specialized cosmetic preparation. Material and methods: The study was conducted on 60 female cancer patients treated at the University Hospital in Zielona Gora, Poland. The patients volunteered for in vivo tests of the cosmetic formulation. Results: The emulsions applied to the patients undergoing chemotherapy significantly increased the hydration of their epidermis. After 4 months of regular use of the preparation, their skin hydration level increased by 22%. The skin hydration of the patients undergoing radiotherapy increased by 3%, as compared with the levels at the beginning of the study. Conclusions: Cosmetic formulations for oncological patients restore the adequate level of skin hydration, aid the reconstruction of the skin and its protective barrier, soothe irritations, accelerate the healing of pathological lesions and prevent their development. Adverse effects may delay or prevent further treatment. Therefore, appropriately tailored care is very important and should not be overlooked.

12.
Cancers (Basel) ; 14(6)2022 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-35326548

RESUMO

Background and purpose: To investigate intraoperative electron radiation therapy (IOERT) as a tumor bed boost during breast conserving surgery (BCS) followed by hypofractionated whole breast irradiation (HWBI) on age-correlated in-breast recurrence (IBR) rates in patients with low- to high-risk invasive breast cancer. Material and methods: BCS and IOERT (11.1 Gy) preceded a HWBI (40.5 Gy) in 15 fractions. Five-year IBR-rates were compared by a sequential ratio test (SQRT) with best evidences in three age groups (35−40 y and 41−50 y: 3.6%, >50 y: 2%) in a prospective single arm design. Null hypothesis (H0) was defined to undershoot these benchmarks for proof of superiority. Results: Of 1445 enrolled patients, 326 met exclusion criteria, leaving 1119 as eligible for analysis. After a median follow-up of 50 months (range 0.7−104), we detected two local recurrences, both in the age group >50 y. With no observed IBR, superiority was demonstrated for the patient groups 41−50 and >50 y, respectively. For the youngest group (35−40 y), no appropriate statistical evaluation was yet possible due to insufficient recruitment. Conclusions: In terms of five-year IBR-rates, Boost-IOERT followed by HWBI has been demonstrated to be superior in patients older than 50 and in the age group 41−50 when compared to best published evidence until 2010.

13.
Pol Przegl Chir ; 95(2): 1-5, 2022 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-36805312

RESUMO

Breast-conserving surgery (BCS) is the gold standard for cancer treatment. The major goal isto achieve tumor-free margins while maintaining a satisfactory aesthetic result. This task canbe accomplished with the use of modern oncoplastic methods.The goal of this study is to provide the preliminary results of surgical treatment for 20 patientswith breast cancer who had their resection defect repaired with pedicled dermal-subcutaneousflaps from nearby breast areas.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/cirurgia , Retalhos Cirúrgicos , Mastectomia Segmentar
14.
Pol Przegl Chir ; 95(4): 1-5, 2022 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-36807097

RESUMO

Introduction Currently, more and more cases of breast cancer are detected in the early stages of advancement. Removal of the minimum required tissue volume ensures that the proper shape of the breast is maintained. On the other hand, it is important to get negative tissue margins. Objective To present your own experience with the use of preoperative breast tumor determination using the Magseed marker. Material and methods On the eve of the procedure, a Magtrace magnetic marker was administered to determine the lymph nodes and, under ultrasound control, a Magseed magnetic marker to the tumor, and the site of the lesion was marked with a skin marker as the operated site. Before the skin incision, the lesion was located using intraoperative ultrasound and the Sentimag probe. After the tumor was excision, the presence of the marker was confirmed in the preparation using the magnetic method and the compatibility of the ultrasound image before and after the procedure. The results of the research group were 23 patients. Radicality of the procedure was achieved in 20 patients (87%). To assess the size of the preparation and tumor, a formula from the work of Angarita et al. on the volume of the ellipsoid was used. It was assessed what part of the excised preparation was a tumor marked using the Magseed marker. Cohorts of 11 patients at the beginning and end of the evaluated group were compared, showing a significant increase in this parameter. Together with the learning curve, you can identify the tumor much more precisely and save healthy breast tissues by improving the aesthetic effect in the breast range. Conclusions The method of localization of non-pallpatory lesions in the mammary gland using the Magseed marker is simple to use, and the high detection rate directly translates into a reduction in the percentage of non-radical treatments in the case of sparing treatment.


Assuntos
Neoplasias da Mama , Glândulas Mamárias Humanas , Humanos , Feminino , Glândulas Mamárias Humanas/patologia , Neoplasias da Mama/cirurgia , Magnetismo , Mastectomia Segmentar , Linfonodos/patologia
15.
Ann Ital Chir ; 92: 505-508, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795110

RESUMO

AIM: Breast implant-associated anaplastic large cell lymphoma, is a rare cancer. Several theories are speculated that may constitute its etiological factors. None of them has been clearly proven. The case report we present is intended to indicate the leading cause of this disease entity. CASE PRESENTATION: Air samples taken in varying conditions at appropriate intervals by the MicroFlow Alfa 90 device in the operating room during five breast implant surgery were analyzed. Samples were taken four times during each operation. After the air was taken and delivered to the laboratory, the plates were immediately incubated under aerobic conditions. The incubation was carried out for up to 7 days. It has been shown that there is a significant difference between the total number of microorganisms during air intake carried out without and with the supply of air to purify the area in a given area by air recirculation of the operating block and cleaning it from bacteria and particles. No air colony-forming units were grown from air samples taken in the supply. However, from air samples taken without blowing, they were raised in various quantities. CONCLUSION: Laminar free airflow used in operating room conditions significantly reduces the risk of infection of the surgical site, and thus may reduce the risk of developing breast implant-associated anaplastic large cell lymphoma. KEY WORDS: BIA-ALCL ethiological factors, Biofilm, Breast implants, Laminar air flow, Surgical site infections.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Biofilmes , Implantes de Mama/efeitos adversos , Neoplasias da Mama/etiologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/epidemiologia , Linfoma Anaplásico de Células Grandes/etiologia , Linfoma Anaplásico de Células Grandes/cirurgia , Salas Cirúrgicas
16.
Front Surg ; 8: 685868, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34235174

RESUMO

Background: Peritoneal lavage cytology in patients with gastric cancer may correlate with an unfavorable prognosis. This study evaluated the presence of free cancer cells in the peritoneal lavage of a population of patients with gastric cancer and its correlation with the outcome of surgical treatment. Methods: One hundred patients diagnosed with gastric or gastrointestinal junction adenocarcinoma underwent surgery. In all patients, a cytological and immunohistochemical analysis of peritoneal lavage was performed. Based on the presence of free cancer cells (fcc) at the cytological and immunohistochemical examination of peritoneal lavage, patients undergoing surgery for gastric cancer were divided into two groups: fcc (+) and fcc (-). Results: A total of 100 patients, 37 women, and 63 men with a median age of 65 years were included in the study. In the entire study group, 16 (16%) patients were positive for the presence of free cancer cells (fcc +) at peritoneal lavage examination. However, in the group of patients who underwent gastrectomy, fcc (+) was found in 10 out of 77 (13%) patients. The presence of cancer cells in peritoneal lavage was a strong predictive factor in an unfavorable outcome after surgery, and 1-year and 2-year patient survival was 34 and 0% in fcc (+) patients and 79 and 59% in fcc (-), respectively. Moreover, the presence of free cancer cells was associated with a five-fold increased risk of death within 2 years after surgery. When analyzing the group of patients undergoing R0/R1 surgery, this difference was even more significant (p < 0.0001). Conclusions: The presence of free cancer cells in peritoneal lavage may significantly affect the outcome of patients with gastric cancer. Radical surgery in patients with free cancer cells in the peritoneal lavage did not result in a survival advantage. Identification of free cancer cells could help for a better stratification of gastric cancer patients, identifying those patients who could better benefit from a radical surgical treatment, finally improving long-term survival.

17.
Cancers (Basel) ; 13(7)2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33805367

RESUMO

In the last two decades, surgical methods for axillary staging in breast cancer patients have become less extensive, and full axillary lymph node dissection (ALND) is confined to selected patients. In initially node-positive patients undergoing neoadjuvant chemotherapy, however, the optimal management remains unclear. Current guidelines vary widely, endorsing different strategies. We performed a literature review on axillary staging strategies and their place in international recommendations. This overview defines knowledge gaps associated with specific procedures, summarizes currently ongoing clinical trials that address these unsolved issues, and provides the rationale for further research. While some guidelines have already implemented surgical de-escalation, replacing ALND with, e.g., sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) in cN+ patients converting to clinical node negativity, others recommend ALND. Numerous techniques are in use for tagging lymph node metastasis, but many questions regarding the marking technique, i.e., the optimal time for marker placement and the number of marked nodes, remain unanswered. The optimal number of SLNs to be excised also remains a matter of debate. Data on oncological safety and quality of life following different staging procedures are lacking. These results provide the rationale for the multinational prospective cohort study AXSANA initiated by EUBREAST, which started enrollment in June 2020 and aims at recruiting 3000 patients in 20 countries (NCT04373655; Funded by AGO-B, Claudia von Schilling Foundation for Breast Cancer Research, AWOgyn, EndoMag, Mammotome, and MeritMedical).

18.
Contemp Oncol (Pozn) ; 25(4): 291-294, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35079237

RESUMO

INTRODUCTION: Infection is one of the most common complications of breast reconstruction. The presence of bacterial biofilm on the implant surface does not always manifest itself clinically as an infection. Still little is known about the factors that trigger the transition from a normal to a pathological state. The aim of study: To examine a specific profile of microorganisms associated with a tissue expander, and to ascertain whether the collection of intraoperative bacteriological swabs constitutes a significant predictive factor. Material and methods: A 2-centre review of outcomes of breast cancer patients who underwent immediate 2-stage expander-implant breast reconstruction between June 2020 and September 2021 was conducted. During this period, 68 replacements of expanders with implants from 56 women were performed. A bacteriological swab was taken from each expander compartment, and microbiological culture was performed. Patients' characteristics were taken into consideration. RESULTS: Tissue expanders were implanted from 2 to 26 months. Seven patients had an emergency expander removed due to infection or damage to the device. Out of all 56 patients evaluated, 47 had a negative and 9 had a positive culture, 1 in both breasts. The results did not correlate closely with the clinical status. CONCLUSIONS: Bacteria colonize both clinically normal and infected expanders. It is difficult to determine the specific flora associated with the pocket after expander-based reconstruction, and taking a bacteriological swab each time as a standard does not influence the success of treatment.

19.
Pol Przegl Chir ; 92(4): 54-57, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32908014

RESUMO

We are reporting a case of a pancreatic-pleural fistula causing epigastric pain. Chest radiograph revealed pleural effusion reaching the seventh rib. Thoracocentesis was performed and 1600 mL of brownish fluid was removed, which showed an elevated amylase level. Ultimately, the diagnosis was confirmed by computed tomography. Due to the failure of medical and endoscopic treatment, the decision was made to perform surgery. It resulted in total pancreatectomy.


Assuntos
Dor Abdominal , Fístula Pancreática , Derrame Pleural , Dor Abdominal/etiologia , Humanos , Pâncreas/diagnóstico por imagem , Pâncreas/cirurgia , Fístula Pancreática/diagnóstico por imagem , Derrame Pleural/complicações , Derrame Pleural/diagnóstico por imagem
20.
Contemp Oncol (Pozn) ; 24(1): 51-54, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32514238

RESUMO

INTRODUCTION: Many early-stage breast cancers are not palpable and thus must be localized before surgery. Detecting these lesions is crucial before they become clinically symptomatic to avoid morbidity and mortality. Nowadays, there are several new alternative techniques to traditional needle/wire localization available. These methods allow for better surgical margins, decreased costs and operating room delays, as well as improved patient satisfaction. The purpose of this study is to evaluate the nonradioactive inducible magnetic seed system Magseed (Endomagnetics Ltd, Cambridge, UK) for preoperative localization of nonpalpable breast lesions. To our knowledge, this report documents the first clinical experience with Magseed in Poland. MATERIAL AND METHODS: A single-institution case report of 10 women with nonpalpable breast lesions localized and excised by using the Magseed surgical guidance system between November 2017 and May 2018. RESULTS AND CONCLUSIONS: Magseed is an easy, sensitive and effective localization method. It is beneficial for oncoplastic outcomes and for scheduling efficiency, which overcomes many limitations of other localization methods. Surgical specimen margins were evaluated in 90% of cases as negative, with no additional re-excision. Only one patient with ductal carcinoma in situ had a positive tumor margin at the axillary side.

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