Recent Developments in Breast Cancer Imaging

Purpose: Breast cancer stands as a primary contributor to cancer-related fatalities among women globally, underscoring the significance of early detection for better prognosis. Innovative imaging methods and biochemical indicators have emerged to augment the diagnosis of breast cancer; however, a systematic assessment of their clinical effectiveness and performance is imperative. Materials and Methods: It was conducted a comprehensive literature review by systematically searching PubMed and Scopus databases. Was included pertinent publications from the period spanning 2010 to 2022. The search terms employed were "breast cancer," "diagnosis," "imaging modalities," and "biomarkers”. Results: Emerging imaging methods such as contrast-enhanced spectral mammography (CESM), diffusion-weighted magnetic resonance imaging (DW-MRI), and positron emission tomography-computed tomography (PET-CT) have exhibited promising outcomes in the realm of breast cancer diagnosis. CESM amalgamates the benefits of mammography and contrast-enhanced MRI, delivering heightened sensitivity and specificity. DW-MRI is a non-intrusive approach adept at identifying alterations in the diffusion characteristics of malignant tissues. PET-CT furnishes valuable functional insights into tumor metabolism and angiogenesis. Regarding biochemical markers, including carbohydrate antigen 15-3 (CA 15-3), carcinoembryonic antigen (CEA), and cancer antigen 125 (CA 125), these have been extensively scrutinized in the context of breast cancer diagnosis. Nevertheless, their diagnostic efficacy remains constrained due to their relatively low sensitivity and specificity, and they are predominantly employed for monitoring disease progression and gauging treatment response. Conclusions: Innovative imaging methods like CESM, DW-MRI, and PET-CT have displayed encouraging outcomes in the diagnosis of breast cancer. However, it is imperative to conduct more in-depth assessments to ascertain their clinical applicability and cost-effectiveness. The potential synergy of integrating imaging techniques with biochemical markers holds promise for augmenting diagnostic precision and mitigating the occurrence of false-positive and false-negative results

Total Colpectomy Increases the Risk of Postoperative Hydronephrosis in Vaginal Cancer Patients

Purpose: Due to the rarity of vaginal cancer, surgical treatment results, and postoperative complications have been poorly described in the literature. The aim of this study was to improve current knowledge about the incidence of hydronephrosis following the surgical treatment of vaginal cancer. Materials and methods: 32 patients with vaginal cancer of the middle and upper third were matched with 32 cervical cancer patients (stages I and II) for comparison of long-term urological postoperative complications. All patients underwent radical surgical treatment and all stage II patients underwent neoadjuvant radiotherapy. Results: Hydronephrosis had a significantly higher incidence in the vaginal cancer group (p = 0.04), with 14 patients (43.8%) being diagnosed with this complication compared to only 5 patients (15.6%) in the cervical cancer group. Among patients that received radiotherapy, 40.1% (n = 9) and 22.7% ( = 5) of vaginal, respectively cervical cancer patients were found with postoperative hydronephrosis. Conclusions: In vaginal cancer patients total colpectomy increases the risk of developing postoperative hydronephrosis, especially if neoadjuvant radiotherapy has been applied

Nerve changes associated with post thoracotomy pain syndrome

Background. Chronic post-thoracotomy pain (PTPS) is a frequent complication of thoracic operations. Sometimes the pain is excruciating enough to impair activities of daily living (ADL). All thoracic procedures have the potential to cause trauma to the intercostal nerves due to retractor use, chest closure techniques, and or wound healing. In our study, we analyzed the microscopic aspects of the nerves involved in the healing process, to better understand the histopathology of chronic pain. Methods. 29 patients with PTPS underwent intercostal neurectomy to alleviate the symptoms. Microscopic specimens harvested during the surgeries were sent to our pathology unit for evaluation. The following data regarding the surgical procedures was collected: surgical approach, chest closure type, number of excised nerves, and time interval from previous surgery to neurectomy. Results. A mean of 2.34±1.11 nerves were excised. Microscopy of the specimens revealed: fibrosis, hyalinization of the epineurium and perineurium, intense hyperemia of the blood capillaries, and interstitial edema. 7 cases presented with myxoid degeneration of epineurium and perineurium. In all the cases, endoneurium, myelin sheaths, and axons were interrupted. The endoneurium showed the presence of hyperemic dilated capillaries. The segmental cytoplasmic vacuolization of Schwann’s cells with the total disappearance of axons was also noted. 60% of the examined specimens had intraneural myxoid degeneration, with highly dense irregular connective tissue around nerve fibers. Conclusion. The pathologic findings in the structure of the intercostal nerves obtained from the patients are indicative of the involvement of the wound healing mechanisms in PTPS. The negative impact of wound healing could be considered a key component in the development of intense chronic pai