Health-related Quality of Life in Vacuum-Assisted Breast Biopsy: short-term effects, long-term effects and predictors

<p>Abstract</p> <p>Background</p> <p>The impact of Vacuum-assisted breast biopsy (VABB, 11-Gauge) upon Health-related Quality of Life (HRQoL) remains an open field. This study aims to: i) assess short-term (4 days after VABB) responses in terms of HRQoL after VABB, ii) evaluate long-term (18 months after VABB) responses, if any, and iii) examine whether these responses are modified by a variety of possible predictors (anthropometric, sociodemographic, lifestyle habits, breast-related parameters, reproductive history, VABB-related features and complications, seasonality).</p> <p>Methods</p> <p>This study included 102 eligible patients undergoing VABB and having benign lesions. A variable number of cores (24-96 cores) has been excised. HRQoL was assessed by EQ-5D and SF-36^®questionnaires: i) in the morning of the VABB procedure day (baseline measurement), ii) four days after VABB (early post-biopsy measurement) and iii) 18 months after VABB (late post-biopsy measurement). Statistical analysis comprised two steps: i. evaluation of differences in EQ-5D/SF-36 dimensions and calculated scores (baseline versus early post-biopsy measurement and baseline versus late post-biopsy measurement) and ii. assessment of predictors through multivariate linear, logistic, ordinal logistic regression, as appropriate.</p> <p>Results</p> <p>At baseline patients presented with considerable anxiety (EQ-5D anxiety/depression dimension, EQ-5D TTO/VAS indices, SF-36 Mental Health dimension). At the early post-biopsy measurement women exhibited deterioration in Usual Activities (EQ-5D) and Role Functioning-Physical dimensions. At the late measurement women exhibited pain (EQ-5D pain/discomfort and SF-36 Bodily Pain), deterioration in Physical Functioning (SF-36 PF) and overall SF-36 Physical Component Scale (PCS). Mastalgia, older age and lower income emerged as significant predictors for baseline anxiety, whereas seasonality modified early activities-related responses. Pain seemed idiosyncratic.</p> <p>Conclusions</p> <p>The HRQoL profile of patients suggests that VABB exerts effects prior to its performance at a psychological level, immediately after its performance at a functioning-physical level and entails long-term effects associated with pain.</p

Volume of blood suctioned during vacuum-assisted breast biopsy predicts later hematoma formation

<p>Abstract</p> <p>Background</p> <p>To evaluate whether the volume of blood suctioned during vacuum-assisted breast biopsy (VABB) is associated with hematoma formation and progression, patient's age and histology of the lesion.</p> <p>Findings</p> <p>177 women underwent VABB according to standardized protocol. The volume of blood suctioned and hematoma formation were noted at the end of the procedure, as did the subsequent development and progression of hematoma. First- and second-order logistic regression was performed, where appropriate. Cases with hematoma presented with greater volume of blood suctioned (63.8 ± 44.7 cc vs. 17.2 ± 32.9 cc; p < 0.001, Mann-Whitney-Wilcoxon test for independent samples, MWW); the likelihood of hematoma formation was increasing till a volume equal to 82.6 cc, at which the second-order approach predicts a maximum. The volume of blood suctioned was positively associated with the duration of the procedure (Spearman's rho = 0.417, p < 0.001); accordingly, hematoma formation was also positively associated with the latter (p = 0.004, MWW). The volume of blood suctioned was not associated with patients' age, menopausal status and histopathological diagnosis.</p> <p>Conclusion</p> <p>The likelihood of hematoma is increasing along with increasing amount of blood suctioned, reaching a plateau approximately at 80 cc of blood lost.</p

Secondary breast lymphoma diagnosed by vacuum-assisted breast biopsy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Breast lymphoma, either as a manifestation of primary extranodal disease or as secondary involvement, is a rare malignancy, and its diagnosis, prognosis, and treatment have not been clearly defined. On the other hand, Vacuum-assisted breast biopsy (VABB) is a minimally invasive technique with ever-growing use for the diagnosis of mammographically detected, non-palpable breast lesions.</p> <p>Case presentation</p> <p>A symptom-free, 56-year-old woman presented with a non-palpable BI-RADS 4B lesion without microcalcifications. She had a positive family history for breast cancer and a history of atypical ductal hyperplasia in the ipsilateral breast four years ago. She reported having been treated for non-Hodgkin lymphoma 12 years ago. With the suspicion of breast cancer, mammographically guided VABB with 11-gauge probe (on the stereotactic Fisher's table) was performed. VABB made the diagnosis of a non-Hodgkin, grade II, B-cell germinal-center lymphoma. VABB yielded enough tissue for immunohistochemistry/WHO classification.</p> <p>Conclusion</p> <p>This is the first case in the literature demonstrating the successful diagnosis of breast lymphoma by VABB, irrespectively of the level of clinical suspicion. It should be stressed that VABB was able to yield enough tissue for WHO classification. In general, lymphoma should never be omitted in the differential diagnosis, since no pathognomonic radiologic findings exist for its diagnosis.</p

Is zero underestimation feasible? Extended Vacuum-assisted breast biopsy in solid lesions – a blind study

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Giving your last gift: A study of the knowledge, attitude and information of Greek students regarding organ donation

Background: Organ donation rates in Greece are the lowest in the European Union. Studying and improving young students’ awareness may increase organ donation rates. This study aimed to investigate young students’ knowledge, attitude and information regarding organ donation and whether they are modified by putative predictors. Material/Methods: A 62-item electronic questionnaire was sent to 1451 eligible students aged 18–30 years in 16 Greek public technical schools. Two composite scales (knowledge and attitude) were created. The multivariate statistical analysis included ordinal logistic and linear regression, as appropriate. Results: Only 37.9% of the students knew the correct definition of organ donation, 40.3% knew which organs can be donated, 27.4% were informed about the new Greek legislation, and 83.1% acknowledged the need for better information. Although 60.5% would donate an organ after death, only 16.1% would become living donors. Although 83.1% of the students declared knowing what brain death means, 18.6% believe that a brain-dead person could fully recover and 32.3% are unsure about it. Being a health professional or a blood donor, the parent’s educational level, the wish to donate all organs after death, the information from announcements or posters, the fear of organ removal after death without prior consent, the consent for autopsy, the wish for better information, and the misbelief that a brain-dead person could fully recover emerged as important predictors of the knowledge and attitude, regarding organ donation. Conclusions: An important lack of knowledge and misperceptions were noted regarding organ donation. Significant predictors were identified