Ultrasound guided surgery under Dilutional Local Anaesthesia and no sedation in breast cancer patients

The Surgeon ◽  
2020 ◽  
Vol 18 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Muhammad Nadeem ◽  
Ajay Sahu
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Local Anaesthesia ◽  
Breast Cancer Patients ◽  
Ultrasound Guided ◽  
Guided Surgery

scholarly journals Can We Identify or Exclude Extensive Axillary Nodal Involvement in Breast Cancer Patients Preoperatively?

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Martijn Leenders ◽  
Gaëlle Kramer ◽  
Kamar Belghazi ◽  
Katya Duvivier ◽  
Petrousjka van den Tol ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Needle Biopsy ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Nodal Involvement ◽  
Ultrasound Guided ◽  
Axillary Ultrasound ◽  
Pet Ct

Background. Breast cancer treatment has rapidly changed in the last few years. Particularly, treatment of patients with axillary nodal involvement has evolved after publication of several randomized clinical trials. Omitting axillary lymph node dissection in selected early breast cancer patients with one or two positive sentinel nodes did not compromise overall survival nor regional disease control in these trials. Hence, either excluding or identifying extensive axillary nodal involvement becomes increasingly important. Purpose. To evaluate whether the current diagnostic modalities can accurately identify or exclude extensive axillary nodal involvement. Evaluated modalities were axillary ultrasound, ultrasound-guided needle biopsy, MRI, and PET/CT. Methods. A literature search was performed in the Cochrane Library, EMBASE, and PubMed databases up to June 2019. The search strategy included terms for breast cancer, lymph nodes, and the different imaging modalities. Only articles that reported pathological N-stage or the total number of positive axillary lymph nodes were considered for inclusion. Studies with patients undergoing neoadjuvant systemic therapy were excluded. Conclusion. There is no evidence that any of the current preoperative axillary imaging modalities can accurately exclude or identify breast cancer patients with extensive nodal involvement. Both negative PET/CT and negative MRI scans (with gadolinium-based contrast agents) are promising in excluding extensive nodal involvement. Larger studies should be performed to strengthen this conclusion. False-negative rates of axillary ultrasound and ultrasound-guided needle biopsy are too high to rely on negative results of these modalities in excluding extensive nodal involvement.

Intraoperative Ultrasound-Guided Lumpectomy Versus Mammographic Wire Localization for Breast Cancer Patients After Neoadjuvant Treatment

2015 ◽  
Vol 23 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Isabel T. Rubio ◽  
Antonio Esgueva-Colmenarejo ◽  
Martin Espinosa-Bravo ◽  
Juan Pablo Salazar ◽  
Ignacio Miranda ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Neoadjuvant Treatment ◽  
Intraoperative Ultrasound ◽  
Breast Cancer Patients ◽  
Wire Localization ◽  
Ultrasound Guided

3-D MRI guided breast conserving surgery

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 610-610
Author(s):  
K. Hisamatsu
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Tumor Size ◽  
Breast Conserving Surgery ◽  
Resected Specimen ◽  
Tumor Diameter ◽  
Breast Cancer Patients ◽  
3D Mri ◽  
Guided Surgery ◽  
Mri Guided

610 Background: In breast cancer patients, accurate diagnosis of ductal spreading is of great importanace for deciding sugical procedure. The role of imaging diagnosis using 3D-MRI in deciding of ductal spreading was assessed histologically and efficacy of 3D-MRI guided surgery was evaluated. Methods: Preoperative 3D-MRI was underwent 374 cases of breast cancer patients. Images were obtained 371 cases (99%). These patients could be divided into four groups according to 3D-MRI images: pattern 1) localized type, 2) widely enhanced type A (enhanced area: less than Quadrant) and 3) widely enhanced type B (enhanced area: more than Quadrant) and 4) multifocal type. Diagnosis of ductal spreading was confirmed histologically and relation between 3D-MRI patterns and ductal spreading were assessed retrospectively. Local failure of 3D-MRI guided surgery was assessed by 3D-MRI image patterns Results: The rate of histological confirmed ductal spreading were seen in 59% (125/212cases), 86% (49/57 cases) and 83% (19/23cases) of patients with 3D-MRI pattern 1), 2), and 3), respectively. From April 2005, resected specimen was serially step cut and total specimens were evaluated. Tumor diameter from nipple side to lateral margin were measured by MRI and resected specimens, tumor size was correlated between MRI and resected specimens, significantly (n=80, r=0.790887, P < 0.001). Whole breast examination revealed that only 4 cases were multifocal cancer in 17 cases of multifocal image in 3D-MRI. Patient selection for breast conserving surgery was based by 3D-MRI images. The proportion of breast-conserved surgery were obtained 96% (203/212 cases), 86% (49/57 cases), 26% (6/23cases) and 89% (68/76 cases) of patients with 3D-MRI pattern 1), 2), 3), and 4), respectively. Local failures were seen 2cases in pattern 1), one case in 3) and one case in 4) (2–77 months, median follow up 39 months). Conclusions: These results suggest that MRI will be the useful breast imaging tool in diagnosing ductal spreading and tumor size in breast cancer patients. Safety breast conserving surgery was achieved by MRI guided surgery. No significant financial relationships to disclose.

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