scholarly journals Breast Cancer Treatment in a Patient with Decubitus Ulcer Infection Secondary to Spina Bifida: Surgical Resection versus Neoadjuvant Chemotherapy

2021 ◽  
pp. 944-949
Author(s):  
Fumiya Sato ◽  
Akihiko Shimomura ◽  
Kanako Nakayama ◽  
Yukino Kawamura ◽  
Kazuki Hashimoto ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Spina Bifida ◽  
Ductal Carcinoma ◽  
Decubitus Ulcer ◽  
Axillary Lymph ◽  
Total Mastectomy ◽  
Decubitus Ulcers ◽  
Normal Limits ◽  
Lower Limb Paralysis ◽  
The Right

Spina bifida (SB) is a congenital neural tube defect that often presents with neurological disability and decubitus ulcers. A 66-year-old woman with SB presented to our hospital with decubitus ulcers and was treated by a plastic surgeon. She was referred to our department because of a mass measuring 5 × 4 cm in the superolateral quadrant of the right breast. The size of the right axillary lymph node (LN) was 2 × 1 cm. A core-needle biopsy revealed an invasive ductal carcinoma. Total mastectomy and axillary LN dissection were planned. However, 2 days prior to surgery, the size of the mass and the LN rapidly increased to 7 × 4 cm and 3 × 2 cm, respectively. Furthermore, the enlarged LN was close to the thoracodorsal artery. Since complete resection was difficult, neoadjuvant chemotherapy was also administered. On day 11 of neoadjuvant chemotherapy, the patient was febrile and developed a decubitus ulcer infection at the buttock. The neutrophil count was within normal limits; thus, she was not diagnosed with febrile neutropenia. Follow-up computed tomography revealed a shrinking of the mass to 5 × 4 cm after the first cycle of neoadjuvant chemotherapy. After 17 days of antibiotic therapy and drainage, total mastectomy and axillary LN dissection were performed. Due to the risk of recurrence of infection, adjuvant chemotherapy was discontinued and hormone therapy was initiated. In conclusion, indications for chemotherapy should be carefully evaluated in SB patients with lower limb paralysis and decubitus ulcers.

scholarly journals Chyle Leak after Right Axillary Lymph Node Dissection in a Patient with Breast Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Ankita Sarawagi ◽  
Jessica Maxwell
Keyword(s):  
Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Ductal Carcinoma ◽  
Tissue Expander ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Chyle Leak ◽  
The Right

Background. A female patient was diagnosed with a right-sided chyle leak following right skin sparing mastectomy, axillary lymph node dissection, and immediate tissue expander placement in the setting of invasive ductal carcinoma status post neoadjuvant chemotherapy. Summary. Our patient underwent a level I and II right axillary lymph node dissection followed by an axillary drain placement. On the first postoperative day, a change from serosanguinous to milky fluid in this drain was noted. The patient was diagnosed with a chyle leak based on the milky appearance and elevated triglyceride levels in the fluid. While chyle leaks are rare after an axillary dissection and even rarer to present on the right side, it is a complication of which breast surgeons should be aware. The cause of this complication is thought to be due to injury of the main thoracic duct, its branches, the subclavian duct, or its tributaries. Management is usually conservative; however, awareness of this potential complication even on the right side is of the utmost importance Conclusion. Chyle leaks are an uncommon complication of axillary node dissections and even rarer for them to present on the right side. It can be diagnosed by monitoring the drainage for changes in appearance and volume and by conducting supporting laboratory tests. Conservative management is generally suggested.

scholarly journals Effectiveness of Pertuzumab, Trastuzumab, and Docetaxel Combination Neoadjuvant Chemotherapy for HER2-Positive Inflammatory Breast Cancer: A Case Report

Breast Care ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Yuji Yamashita ◽  
Yuko Tanaka ◽  
Seishi Kono ◽  
Meiko Nishimura ◽  
Toru Mukohara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Inflammatory Breast Cancer ◽  
Axillary Lymph Node ◽  
Local Treatment ◽  
Axillary Lymph ◽  
Her2 Positive ◽  
The Right

Background: Inflammatory breast cancer (IBC) is the most aggressive form of primary breast cancer. Case Report: A 40-year-old woman was referred to our hospital for evaluation of an induration in the right breast, suspected to be breast cancer. The tumor was diagnosed as estrogen receptor-negative, progesterone receptor-negative, HER2-positive, T4dN3cM0 stage IIIc IBC with axillary lymph node metastasis. Rather than surgical intervention, we chose a systemic treatment approach with pertuzumab, trastuzumab, and docetaxel (PTD) combination therapy which was shown to be effective for HER2-positive IBC in the NeoSphere trial. After 4 cycles of treatment, the patient had a partial response, allowing mastectomy of the right breast and axillary lymph node dissection to achieve local control. We review this case because of the success of PTD combination neoadjuvant chemotherapy for HER2-positive IBC. Conclusion: To improve the poor prognosis of IBC, combined modality therapy is required, including chemotherapy and local treatment such as surgery and/or radiation therapy. In this case, combination neoadjuvant chemotherapy with PTD for HER2-positive IBC was effective, and this regimen may contribute to further improvements in the cure rate for this malignancy.

scholarly journals Inflammatory breast cancer associated with amyopathic dermatomyositis: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Gaku Inaguma ◽  
Akihiko Shimada ◽  
Junya Tsunoda ◽  
Tomohiko Matsuzaki ◽  
Tomohiko Nishi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Inflammatory Breast Cancer ◽  
Malignant Tumors ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Asian Woman ◽  
Axillary Lymph ◽  
Total Mastectomy

Abstract Background Dermatomyositis is associated with malignant tumors including breast cancer, and inflammatory breast cancer is considered to have a poorer prognosis than most breast cancers. Case presentation A 74-year-old Asian woman, developed erythema on her face, back, and the back of her hands, 3 weeks before attending our department. At the same time, she had noticed a right breast mass and redness of the skin of the breast. The clinical findings and vacuum aspiration biopsy diagnosed inflammatory breast cancer and neoadjuvant chemotherapy was performed. The mass and enlarged axillary lymph nodes had shrunk, therefore a total mastectomy was performed. The sentinel lymph node biopsy was negative. She was discharged 7 days after surgery without any complications. She has received a postoperative aromatase inhibitor and is alive without recurrence. The dermatomyositis also began to improve with the start of her chemotherapy and has not recurred since the surgery. Conclusions Neoadjuvant chemotherapy was performed for inflammatory breast cancer with dermatomyositis, and tumor shrinkage was confirmed. A total mastectomy without axillary lymph node dissection was performed. Dermatomyositis and breast cancer have not recurred. Dermatomyositis may have been a paraneoplastic syndrome due to breast cancer.

scholarly journals Breast cancer with choriocarcinomatous and neuroendocrine features

2001 ◽  
Vol 119 (4) ◽  
pp. 154-155 ◽  
Author(s):  
Osvaldo Giannotti Filho ◽  
Luciana Nakao Odashiro Miiji ◽  
Marta Vainchenker ◽  
Ângela Navarro Gordan
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Giant Cells ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Axillary Lymph ◽  
Brazilian Woman ◽  
The Right

CONTEXT: Breast cancer may express the presence of b-human chorionic gonadotrophin in 12% to 18% of cases, using immunohistochemical reactions. Usually the tumors will show positivity in a few scattered cells. Breast cancer with choriocarcinomatous features, as reported by Saigo and Rosen, is a distinct variant of breast cancer. We report a case of breast cancer with choriocarcinomatous and neuroendocrine features. OBJECTIVE: This is a case report of an invasive ductal carcinoma of the breast with choriocarcinomatous and neuroendocrine features. DESIGN: Case Report. CASE REPORT: A 50-year-old Brazilian woman underwent surgery for a lump in the right breast, which had been first noticed about 3 months earlier. The surgery consisted of quadrantectomy followed by right mastectomy with ipsilateral axillary lymph node dissection. The specimen from the quadrantectomy revealed a 7 x 6.5 x 4.5 cm tumor. Histology of the lesion showed the presence of an invasive ductal carcinoma with areas of giant cells and intense atypia. The immunohistochemistry was positive in the pleomorphic areas for human chorionic gonadotrophin, while the less pleomorphic areas showed positivity for synaptophysin and chromogranin.

scholarly journals Katupila (Securinega leucopyrus) A Boon for Bedsore- A Case Report

2021 ◽  
Vol 20 (4) ◽  
pp. 198
Author(s):  
Snehal Sonani ◽  
Vivekanand Kullolli ◽  
Krishna Thorat
Keyword(s):  
Case Report ◽  
Single Case ◽  
Decubitus Ulcer ◽  
External Pressure ◽  
Decubitus Ulcers ◽  
External Application ◽  
Single Case Report ◽  
Bony Prominence ◽  
The Right ◽  
Patent Medicine

Pressure ulcer is a sequel of tissue necrosis and ulceration due to prolonged pressure. External pressure of more than 30 mmHg on the skin leads to ischemia (reduced blood flow) causing ischeohypoxia, necrosis and ulceration. It is more common between bony prominence and an external surface. It may be due to impaired blood supply, defective nutrition and neurological deficit. Ayurveda describes this type of non-healing ulcer in terms of <em>Dusta vrana</em>, in that context <em>Acharya Sushruta</em> had also mentioned it as “<em>Dirghakalanubandhi</em>” which suggests that these kind of ulcers take longer time to heal due to underlying reasons. This article is about the single case report of a 51-year-old male patient with a stage 3 decubitus ulcer over the right heel since 2 months. As decubitus ulcers especially of stage 3 is difficult to cure, ayurvedic management with internal medication and external therapy was performed in this reported case. For Internal medication, Tablet septilin (A Patent medicine of Himalaya pharmacy, India) and <em>Punarnavadi kashay</em> (A Patent medicine of Vaidhyaratnam pharmacy, India) was used for enhancement of better wound healing. For external application Paste Katupila and honey was applied for 30 days. According to the assessment, wound showed good response within 10 days and was completely healed in 30 days.

scholarly journals Intra-mammary lymph nodes, an overlooked breast cancer prognostic tool?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tarek Hashem ◽  
Ahmed Abdelmoez ◽  
Ahmed Mohamed Rozeka ◽  
Hazem Abdelazeem
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Percutaneous Biopsy ◽  
Preoperative Imaging ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Pathological Features ◽  
Breast Cancer Patients ◽  
Surgical Data

Abstract Background Due to the high variability of incidence and prevalence of intra-mammary lymph nodes (IMLNs), they might be overlooked during clinical and radiological examinations. Properly characterizing pathological IMLNs and detecting the factors that might influence their prevalence in different stages of breast cancer might aid in proper therapeutic decision-making and could be of possible prognostic value. Methods Medical records were reviewed for all breast cancer patients treated at the National Cancer Institute of Cairo University between 2013 and 2019. Radiological, pathological, and surgical data were studied. Results Intra-mammary lymph nodes were described in the final pathology reports of 100 patients. Five cases had benign breast lesion. Three cases had phyllodes tumors and two cases had ductal carcinoma in situ (DCIS). All ten cases were excluded. The remaining 90 cases all had invasive breast cancer and were divided into two groups: one group for patients with malignant IMLNs (48) and another for patients with benign IMLNs (42). Pathological features of the malignant IMLN group included larger mean tumor size in pathology (4.7 cm), larger mean size of the IMLN in pathology (1.7 cm), higher incidence of lympho-vascular invasion (65.9%), and higher rate of extracapsular extension in axillary lymph nodes (57.4%). In addition, the pathological N stage was significantly higher in the malignant IMLN group. Conclusion Clinicians frequently overlook intra-mammary lymph nodes. More effort should be performed to detect them during preoperative imaging and during pathological processing of specimens. A suspicious IMLN should undergo a percutaneous biopsy. Malignant IMLNs are associated with advanced pathological features and should be removed during surgery.

scholarly journals Necessity of sentinel lymph node biopsy in ductal carcinoma in situ patients: a retrospective analysis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Young Duck Shin ◽  
Hyung-Min Lee ◽  
Young Jin Choi
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Metastasis ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Ductal Carcinoma ◽  
Invasive Cancer ◽  
Total Mastectomy ◽  
Core Needle ◽  
Node Metastasis

Abstract Background Sentinel lymph node biopsy (SLNB) is unnecessarily performed too often, owing to the high upstaging rates of ductal carcinoma in situ (DCIS). This study aimed to evaluate the upstaging rates of DCIS to invasive cancer, determine the prevalence of axillary lymph node metastasis, and identify the clinicopathological factors associated with upstaging and lymph node metastasis. We also examined surgical patterns among DCIS patients and determined whether SLNB guidelines were followed. Methods We retrospectively analysed 307 consecutive DCIS patients diagnosed by preoperative biopsy in a single centre between 2014 and 2018. Data from clinical records, including imaging studies, axillary and breast surgery types, and pathology results from preoperative and postoperative biopsies, were extracted. Univariate analyses using Chi-square tests and multiple logistic regression analyses were used to analyse the data. Results The rate of upstaging to invasive cancer was 19.2% (59/307). DCIS diagnosed by core-needle biopsy (odds ratio [OR]: 6.861, 95% confidence interval [CI]: 2.429–19.379), the presence of ultrasonic mass-forming lesions (OR: 2.782, 95% CI: 1.224–6.320), and progesterone receptor-negative status (OR: 3.156, 95% CI: 1.197–8.323) were found to be associated with upstaging. The rate of sentinel lymph node metastasis was only 1.9% (4/202), and all were total mastectomy patients diagnosed by core-needle biopsy. SLNB was performed in 37.2% of 145 breast-conserving surgery patients and 91.4% of 162 total mastectomy patients. Among the 202 patients who underwent SLNB, 145 (71.7%) without invasive cancer on final pathology had redundant SLNB. Two of 59 patients (3.4%) with disease upstaged to invasive cancer had inadequate primary staging of the axilla, as the rate seemed sufficiently small. Conclusions In patients with a preoperative diagnosis of DCIS, although an unavoidable possibility of upstaging to invasive cancer exists, axillary metastasis is unlikely. Only 2.7% of patients with DCIS undergoing total mastectomy were found to have sentinel lymph node metastases. SLNB should not be performed in breast-conserving surgery patients and should be reserved only for total mastectomy patients diagnosed by core-needle biopsy.

scholarly journals Breast Angiosarcoma with a Preoperative Diagnosis of Late Recurrence of Breast Cancer: A Case Report

2021 ◽  
pp. 604-609
Author(s):  
Rika Kouhashi ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Tamami Morisaki ◽  
Sae Ishihara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Preoperative Diagnosis ◽  
Vascular Endothelial Cells ◽  
Interstitial Fibrosis ◽  
Late Recurrence ◽  
Breast Conserving Surgery ◽  
Surrounding Tissue ◽  
Axillary Lymph ◽  
Elevated Lesion ◽  
The Right

Angiosarcoma is a malignant mesenchymal tumor characterized by the presence of vascular endothelial cells. Although rare, angiosarcoma developing in the mammary glands has a poor prognosis. We report a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer. A 78-year-old woman noticed a tumor in her right breast and visited our hospital. The patient had undergone breast-conserving surgery and axillary lymph node dissection from the right breast 12 years before the visit. The tumor was diagnosed as T4bN0M0, stage IIIB. Anastrozole was administered as postoperative adjuvant therapy for 5 years; the patient also received 50-Gy whole-breast radiation therapy after surgery. Physical examination during her visit revealed an elevated lesion with blue purpura around the nipple in the right breast. We performed breast ultrasound and detected a well-defined 19.6 × 16.4 × 10.7 mm hypoechoic tumor in the left subareolar area. The patient underwent core needle biopsy (CNB). Based on the CNB specimen findings, she was suspected to experience late local recurrence after surgery. Therefore, she underwent total mastectomy after breast-conserving surgery. A dark-red tumor sized 18 × 12 mm was found in a specimen from the nipple. The pathological diagnosis of the specimen revealed short spindle-shaped tumor cells with strong nuclear pleomorphism and a significant interstitial fibrosis. Immunohistochemistry using D2-40 and CD31 antibodies showed irregular luminal proliferation at the anastomosis, infiltration into the surrounding tissue, and massive necrosis, thereby leading to the diagnosis of breast angiosarcoma. We have reported a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer.

scholarly journals Cervical Sympathetic Trunk-Centered Inflammatory Myofibroblastic Tumor Complicated with Postoperative First Bite Syndrome

2021 ◽  
Author(s):  
Liu Yang ◽  
Wen Li
Keyword(s):  
Neck Region ◽  
Sympathetic Trunk ◽  
Cervical Sympathetic Trunk ◽  
First Line Therapy ◽  
Normal Limits ◽  
Serum Igg4 ◽  
Postoperative Serum ◽  
Cervical Sympathetic ◽  
The Right ◽  
First Bite Syndrome

AbstractInflammatory myofibroblastic tumors (IMTs) in the head and neck region are common, but those with sympathetic trunk involvement are extremely rare. Here we present a case of cervical sympathetic trunk-centered IMT which is also accompanied by ipsilateral carotid artery, internal jugular vein, and vagus nerve involvement. The patient initially complained of an episodic painful swelling on the right side of the neck and underwent surgery. Preoperative and postoperative serum IgG4 level during 3-year follow-up time is within normal limits. Immunohistochemical study of the tumor has also revealed negativity to IgG4. Postoperative first bite syndrome (FBS) was observed. Surgery seems to be first-line therapy in the patient with IgG4-negative IMT.

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