Problematic aspects of sentinel lymph node biopsy and its relation to previous excisional biopsy in breast cancer

PubMed ID: 20139816Purpose: The aim of the study is to review problematic aspects of sentinel lymph node biopsy (SLNB) and to evaluate the influence of a previous excisional biopsy on these problemsMaterials and Methods: A total of 345 patients were evaluated retrospectively, 156 of them had a previous biopsyTc-99m tin colloid was injected the day before surgery at 4 quadrants around the areola intradermallyProblems complicating SLNB are reviewed in 3 topics: visualization or gamma probe detection problems, dilated lymphatic channels, and misleading activity accumulationResults: SLN detection rate and mean sentinel lymph node numbers were as follows in patients with and without biopsy, respectively: 95.5% versus 99.4% and 1.71 ± 0.97 versus 1.70 ± 0.92Problems complicating the procedure occurred in 20 patients (5.8%)Among these 20 patients, 15 had a prior excisional biopsy, and incisions were located in the upper, outer and periareolar zonesVisualization or gamma probe detection problems occurred in 8 patientsExcept for one with faint uptake in a sentinel node, all had a prior biopsyLymphatic channel dilatation complicated the procedure in 7 patientsOf these 7 patients, 4 had a previous biopsyMisleading activity accumulations compromised SLNB in 5 patients, 4 of whom had a prior biopsyCONCLUSIO

Breast A Study of 20 Cases with Histologic Correlation

ObjectiveTo analyze fine needle aspiration cytology (FNAC) mater material from 20 cases of histologically verified medullary carcinoma (MC) of the breast and correlate the cytomorphologic features with histologic appearance to improve the diagnostic sensitivity and specificity of FNAC.Study DesignWe reviewed the cytologic features of 20 cases of MC of the breast in the archives of Ege University Hospital between 1994 and 2006.ResultsTwenty patients with an aspirate and confirmed diagnosis of MC were identified. Patient age was 30-74 years (mean, 48). The initial cytologic diagnoses were positive for cancer in 17 cases, atypical/suspicious for cancer in 2 cases and negative for cancer in 1 case. The cytologic picture was characterized by cellular smears composed of highly atypical epithelial tumor cells in loosely cohesive sheets and lying singly, admixed with polymorphous lymphocytes, plasma cells and neutrophils. Tumor cells had predominantly abundant finely granular, eosinophilic cytoplasm and moderate to marked nuclear pleomorphism with prominent nucleoli. Histologic examination confirmed that 11 cases were atypical MC and 9 were pure MC.ConclusionBreast MC is a rare, distinct category that appears to have rather characteristic cellular features. Familiarity with the cell components is a prerequisite in cytologic accuracy. (Acta Cytol 2009;53:165173

Breast A Study of 20 Cases with Histologic Correlation

ObjectiveTo analyze fine needle aspiration cytology (FNAC) mater material from 20 cases of histologically verified medullary carcinoma (MC) of the breast and correlate the cytomorphologic features with histologic appearance to improve the diagnostic sensitivity and specificity of FNAC.Study DesignWe reviewed the cytologic features of 20 cases of MC of the breast in the archives of Ege University Hospital between 1994 and 2006.ResultsTwenty patients with an aspirate and confirmed diagnosis of MC were identified. Patient age was 30-74 years (mean, 48). The initial cytologic diagnoses were positive for cancer in 17 cases, atypical/suspicious for cancer in 2 cases and negative for cancer in 1 case. The cytologic picture was characterized by cellular smears composed of highly atypical epithelial tumor cells in loosely cohesive sheets and lying singly, admixed with polymorphous lymphocytes, plasma cells and neutrophils. Tumor cells had predominantly abundant finely granular, eosinophilic cytoplasm and moderate to marked nuclear pleomorphism with prominent nucleoli. Histologic examination confirmed that 11 cases were atypical MC and 9 were pure MC.ConclusionBreast MC is a rare, distinct category that appears to have rather characteristic cellular features. Familiarity with the cell components is a prerequisite in cytologic accuracy. (Acta Cytol 2009;53:165173

Fine needle aspiration cytology of mammary carcinoma with choriocarcinomatous features: a report of 2 cases.

BACKGROUND: Neoplasms of the breast containing multinucleated giant cells (MGCs) include both benign and malignant entities, such as benign soft tissue giant cell tumors, atypical fibrous histiocytoma, sarcomas, metaplastic carcinomas and the uncommon carcinomas containing osteoclast-like giant cells (OGC). Breast carcinoma with choriocarcinomatous features (BCCF) is a distinct variant of breast cancer. CASES: We report the cytologic features, pathologic findings and immunohistochemical profile in 2 cases of this unusual variant of breast carcinoma. Two women aged 53 and 50 years women presented with a history of left and right breast lump but no local lymphadenopathy, respectively. Fine needle aspiration cytology (FNAC) of both cases revealed abundant MGC with highly pleomorphic tumor cells in the hemorrhagic necrotic background. Both of the cases were histopathologically diagnosed as BCCF. CONCLUSION: Choriocarcinomatous differentiation with multinucleated syncytiotrophoblast-like giant cells is extremely rare in breast tumors. Although rare, FNAC of breast cancer with pleomorphic MGC requires careful search for differential diagnosis; breast carcinoma with giant cell features (choriocarcinomatous features, OGC features) must be differentiated from metastatic tumors and other breast lesions containing giant cells

Prognostic factors affecting ipsilateral tumor recurrence and distant metastasis after breast-conserving surgery

10th European Breast Cancer Conference (EBCC) -- MAR 09-11, 2016 -- Amsterdam, NETHERLANDSWOS: 00037177950031

Public Health Reports ; v. 54, no. 25 : cover

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Effects of somatostatin analogues and vitamin C on bacterial translocation in an experimental intestinal obstruction model of rats

WOS: 000087848300006PubMed ID: 10933113The passage of viable endogenous bacteria and their products across the intact intestinal mucosal barrier, disseminating to the mesenteric lymph nodes, peritoneal cavity, spleen, liver, and circulation, is defined as bacterial translocation. Intestinal obstruction induces bacterial translocation due to mucosal disruption, motility dysfunction, and increased intestinal volume, leading to bacterial overgrowth. In a rat model of intestinal obstruction, the effects of both high-dose vitamin C (350 mu g/kg), an antioxidant agent known to have a cytoprotective effect in ischemia-reperfusion injury, and somatostatin (20 mu g/kg), a gastrointestinal antisecretory agent, in preventing bacterial translocation were studied. Both intestinal and liver samples from the rats was observed, and it was found that the rate of bacterial translocation was 100% in the control group, and only 43% for the rats who were given intraperitoneal vitamin C and somatostatin. The difference was statistically significant. In conclusion, we are convinced that vitamin C and somatostatin analogues may have protective effects against bacterial translocation in mechanical bowel obstruction

Fine needle aspiration cytologic features of medullary carcinoma of the breast: A study of 20 cases with histologic correlation

Objective To analyze fine needle aspiration cytology (FNAC) material from 20 cases of histologically verified medullary carcinoma (MC) of the breast and correlate the cytomorphologic features with histologic appearance to improve the diagnostic sensitivity and specificity of FNAC. Study Design We reviewed the cytologic features of 20 cases of MC of the breast in the archives of Ege University Hospital between 1994 and 2006. Results Twenty patients with an aspirate and confirmed diagnosis of MC were identified. Patient age was 30-14 years (mean, 48). The initial cytologic diagnoses were positive for cancer in 17 cases, atypical/suspicious for cancer in 2 cases and negative for cancer in 1 case. The cytologic picture was characterized by cellular smears composed of highly atypical epithelial tumor cells in loosely cohesive sheets and lying singly, admixed with polymorphous lymphocytes, plasma cells and neutrophils. Tumor cells had predominantly abundant finely granular, eosinophilic cytoplasm and moderate to marked nuclear pleomorphism with prominent nucleoli. Histologic examination confirmed that 11 cases were atypical MC and 9 were pure MC. Conclusion Breast MC is a rare, distinct category that appears to have rather characteristic cellular features. Familiarity with the cell components is a prerequisite in cytologic accuracy. © The International Academy of Cytology