Can preoperative lymphoscintigraphy be used as a guide in treatment planning of breast cancer?

Purpose: The purpose of this study was to map the lymphatic drainage patterns of breast cancer with lymphoscintigraphy to evaluate the variability of drainage and to determine whether lymphatic mapping can help to increase the certainty of breast cancer staging. Materials an

Tc-99(m)-tetrofosmin scintigraphy in the evaluation of palpable breast masses

Tl-201 and Tc-99(m)-MIBI have been used io evaluate palpable breast masses. The aim of this study was to evaluate the potential of Tc-99(m)-tetrofosmin as a new tumour localizing agent in patients with palpable breast masses. Nineteen palpable breast masses were evaluated in 18 patients. Each patient received 740 MBq Tc-99(m)-tetrofosmin intravenously. Ten minutes after the injection, planar breast images in the anterior, right lateral and left lateral views were obtained with the patient in the supine position. Mammography and ultrasonography were performed in all patients. Biopsy or mastectomy with axillary dissection was performed in all patients. Thirteen of 14 primary breast tumours were detected (9 invasive ductal carcinomas, 3 invasive lobular carcinomas, 1 papillary carcinoma). One patient with mucinous carcinoma did not demonstrate Tc-99(m)-tetrofosmin accumulation. Four of five patients with histopathologically proven benign lesions did not demonstrate Tc-99(m)-tetrofosmin accumulation (2 fibrocystic diseases, 2 fibroadenomas). Tc-99(m)-tetrofosmin accumulation was seen in a patient with chronic mastitis. The sensitivity and specificity of Tc-99(m)-tetrofosmin for malignant breast lesions was 92 and 80% respectively. Four of seven (57%) axillary lymph node metastases showed Tc-99(m)-tetrofosmin uptake. In conclusion, Tc-99(m)-tetrofosmin shows real promise for use in evaluating patients with palpable breast masses

SURGICAL-TREATMENT OF HEPATIC HYDATID-DISEASE

The results of surgery in 38 patients with hepatic hydatid disease are described. Cystectomy was done in four patients with small peripheral cysts. For them the mean postoperative stay was 8.2 days. Partial cystectomy, introflexion and omentoplasty were performed in 28 patients with uncomplicated large cysts. The mean postoperative stay for these patients was 8.6 days. One patient in this group died of massive hemorrhage and disseminated intravascular coagulation. Exploration of the common bile duct and choledochoduodenostomy were required in three patients who had large cysts complicated by rupture into the biliary tree. This complication resulted in a mean postoperative stay of 11.5 days. Three patients who had cysts complicated by pyogenic infection were treated with tube drainage. They were discharged with their tubes in place after a mean hospital stay of 26.5 days

The use of the ipsilateral versus contralateral pedicle and vertical versus horizontal flap inset models in TRAM flap breast reconstruction: The aesthetic outcome

The use of an ipsilateral or a contralateral rectus abdominis muscle as a pedicle and comparison of their advantages and disadvantages in TRAM flap breast reconstruction have been reported in the literature. In our clinical experience with 22 pedicled TRAM flap breast reconstructions, the use of either an ipsilateral or contralateral pedicle was found to be equivocal regarding the flap viability and the aesthetic outcome. Thus, it seems better to decide their use according to the needs of an individual patient