Axillary sentinel lymph node biopsy after mastectomy: a case report

<p>Abstract</p> <p>Background</p> <p>Sentinel lymph node biopsy has been established as the preferred method for staging early breast cancer. A prior history of mastectomy is felt to be a contraindication.</p> <p>Case presentation</p> <p>A patient with recurrent breast cancer in her skin flap was discovered to have positive axillary sentinel nodes by sentinel lymph node biopsy five years after mastectomy for ductal carcinoma in situ.</p> <p>Conclusion</p> <p>A prior history of mastectomy may not be an absolute contraindication to sentinel lymph node biopsy.</p

Factors predicting clinically significant fatigue in women following treatment for primary breast cancer

Cancer-related fatigue is common, complex, and distressing. It affects 70–100% of patients receiving chemotherapy and a significant number who have completed their treatments. We assessed a number of variables in women newly diagnosed with primary breast cancer (BrCa) to determine whether biological and/or functional measures are likely to be associated with the development of clinically significant fatigue (CSF). Two hundred twenty-three women participated in a study designed to document the impact of the diagnosis and treatment of primary breast cancer on function. Forty-four had complete data on all variables of interest at the time of confirmed diagnosis but prior to treatment (baseline) and ≥9 months post-diagnosis. Objective measures and descriptive variables included history, physical examination, limb volume, hemoglobin, white blood cell count, and glucose. Patient-reported outcomes included a verbal numerical rating of fatigue (0–10, a score of ≥4 was CSF), five subscales of the SF-36, Physical Activity Survey, and Sleep Questionnaire. At baseline, the entire cohort (n = 223) and the subset (n = 44) were not significantly different for demographic, biological, and self-reported data, except for younger age (p = 0.03) and ER+ (p = 0.01). Forty-five percent had body mass index (BMI) ≥ 25, 52% were post-menopause, and 52% received modified radical mastectomy, 39% lumpectomy, 52% chemotherapy, 68% radiation, and 86% hormonal therapy. Number of patients with CSF increased from 1 at baseline to 11 at ≥9 months of follow-up. CSF at ≥9 months significantly correlated with BMI ≥ 25, abnormal white blood cell count, and increase in limb volume and inversely correlated with vigorous activity and physical function (p < 0.05). Fatigue increases significantly following the treatment of BrCa. Predictors of CSF include high BMI and WBC count, increase in limb volume, and low level of physical activity. These are remediable

Multiple Schwannomas in a Patient with Gynecomastia

A 29-year-old man presented for evaluation of a left subareolar mass. It had been present for 8 years but had recently begun to rapidly enlarge. He denied nipple discharge or chest-wall changes. Family history was notable only for a grandmother with breast cancer. There was no personal history suggesting neurofibromatosis. He had no history of testicular masses, chest trauma, headaches, vision changes, or neoplasms. He had occasionally used dietary supplements while wrestling competitively in high school but otherwise took no medications, occasionally used alcohol, and did not smoke or use recreational drugs. A large, firm, and palpable left subareolar mass without skin changes was identified on exam (Fig. 1). There was right-sided gynecomastia, but no café au lait spots or freckling of the axillae

Segmental Limb Volume Change as a Predictor of the Onset of Lymphedema in Women With Early Breast Cancer

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146851/1/pmr21098.pd

Leg power, pelvic movement and physical activity after periacetabular osteotomy. A prospective cohort study.

Purpose To investigate changes in leg power, pelvic movement and patient-reported outcome in patients with hip dysplasia one year after periacetabular osteotomy.          Methods Forty-one patients (7 males) with a mean age of 28.8 years scheduled for periacetabular osteotomy were tested before surgery, and 4 and 12 months after. Leg power, pelvic range of motion and the Hip and Groin Outcome Score (HAGOS) was collected.Results One year after surgery, power in the operated leg had improved (p=0.004) and there was no significant difference between power in the operated leg and contralateral leg (p=0.22). In the frontal plane, pelvic range of motion decreased significant during stair-climbing and stepping down. The same pattern was seen in the sagittal plane but the changes were non-significant. All subscales on the HAGOS improved significantly over time (p&lt;0.001).Conclusion Leg power and pelvic range of motion in patients with symptomatic hip dysplasia improved 12 months after periacetabular