RESUMEN
A 50's underwent gastrectomy for gastric cancer 4 years before. He had received chemotherapy for para-aortic lymph node metastases. A central venous catheter with a subcutaneous port was implanted via the right subclavian vein, under ultrasonographic guidance, 1 year 3 months earlier. The patient complained of swelling in his right chest during intravenous injection of ramucirumab and paclitaxel via the port. A chest radiograph revealed that a catheter fracture. A CT scan showed that the fractured catheter had lacerated the pectoralis minor muscle and the tip was in the right inferior pulmonary artery. The catheter fragment was removed using a pigtail catheter and a snare catheter via a percutaneous transfemoral approach, without any complication. The catheter was cut at 15.5 cm from the tip. This fracture was thought to be caused by a kink in the pectoralis muscle.
Asunto(s)
Cateterismo Venoso Central/efectos adversos , Catéteres Venosos Centrales/efectos adversos , Laceraciones/etiología , Músculos Pectorales/diagnóstico por imagen , Neoplasias Gástricas/tratamiento farmacológico , Cateterismo Venoso Central/instrumentación , Catéteres de Permanencia/efectos adversos , Gastrectomía , Humanos , Laceraciones/diagnóstico por imagen , Laceraciones/cirugía , Masculino , Persona de Mediana Edad , Neoplasias Gástricas/cirugía , Tomografía Computarizada por Rayos XRESUMEN
We conducted a case-control study to examine the relationship between breast density (BD) on mammography and breast cancer risk for postmenopausal Japanese women. The mammograms (205 cases and 223 controls) were classified by two doctors employing Wolfe's classification and used to measure BD with original computer software. A weak relationship between breast cancer risk and the parenchymal pattern of Wolfe's classification was found. The BD measured with the computer software, however, showed a significant relationship with breast cancer risk. Analysis after adjustment for epidemiologic factors showed that women in the quintile with the highest BD had a 3.02 times higher risk of breast cancer than those in the quintile with the lowest density. Since mammographic BD is clearly associated with breast cancer risk for postmenopausal Japanese women, our software can be expected to become a useful tool for objective risk assessment of breast cancer.
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Mamografía/métodos , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/epidemiología , Estudios de Casos y Controles , Femenino , Humanos , Japón , Persona de Mediana Edad , Posmenopausia , Análisis de Regresión , Reproducibilidad de los Resultados , Medición de RiesgoRESUMEN
Accurate risk assessment for individual women is essential for effective screening of breast cancer (BC) in Japan, because the incidence of BC is still lower than in Western countries. We investigated various new risk factors of BC by means of case control studies and found that serum estrone and adiponectine levels as well as mammographic breast density were significantly correlated to BC risk. Combining these new factors and conventional risk factors of BC may result in a new and useful risk assessment tool, may improve the cost-effectiveness of screening, and may enable us to reduce the BC mortality of Japanese women.