Cosmesis in patients with breast neoplasia submitted to the hypofractionated radiotherapy with of intensity-modulated beam

SUMMARY OBJECTIVE: To assess the cosmetic satisfaction of patients diagnosed with breast cancer submitted to the hypofractionated radiotherapy with IMRT (hIMRT) technique and its correlation with dosimetric data of the radiotherapy planning. MATERIALS AND METHODS: The retrospective cohort study that assessed women with a diagnosis of malignant breast neoplasia submitted to the conservative treatment or radical mastectomy and treated with hIMRT. In the period between August 2007 to December 2014, in a philanthropic / private institution, 170 records were selected. The cosmetic assessment was carried out by means of the Harvard/RTOG/NSABP scale with one-year minimum range after treatment. The collected dosimetric data were: breast / chest wall volume, volume that received 95% (V95%) and 107% (V107%) of the prescribed dose. RESULTS: The volume of the treated breasts ranged from 169 to 2.103 ml (median = 702; IQR: 535 to 914 ml). Median V95% was 86.7% (54.6-96.6%; IQR: 80.0% to 90.6%); eight (5.7%) patients had V95% higher than 95%. Median V107% was 0% (0%-16.3%; IQR: 0.0% to 0.3% and 13); 9.3% patients had V107% higher than 2%. One hundred and thirty-three (78.2%) patients responded to the cosmetic assessment: 99 (74.4%) considered the cosmetic results excellent. Significant associations between cosmetic assessment and breast volume (p=0.875), V95% (p=0.294) e V107% (p=0.301) were not found. CONCLUSION: The cosmetic results showed favorable when using hIMRT, and the lack of correlation with usual the dosimetric data illustrates the capacity of hIMRT to minimize the heterogeneity of the dose in this endpoint, even in voluminous breasts.

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Evaluation of Breast Lumps by Ultrasound and Correlation with Histological Findings

Journal of Surgical Sciences ◽

10.3329/jss.v23i1.44238 ◽

2020 ◽

Vol 23 (1) ◽

pp. 10-12

Author(s):

Nelema Jahan ◽

Md. Mamunur Rahman ◽

Mohammad Shahidul Alam ◽

Md Saiful Islam

Keyword(s):

Histopathological Examination ◽

Breast Diseases ◽

Histopathological Study ◽

Common Symptom ◽

Breast Lump ◽

Histopathological Findings ◽

Malignant Breast ◽

Breast Lumps ◽

One Year ◽

A Prospective Study

Background: A breast lump is the most common symptom associated with both benign and malignant breast diseases. Therefore, a distinction of benign from malignant lump is of importance for proper management. Though a definitive diagnosis is possible with imaging for all the lesions, histopathological study is proven essential for confirming the diagnosis. Objective: The objective of this study was to evaluate the role of USG and histopathological findings of different breast lump in diagnosis and their comparison. Methods: A prospective study was conducted over a period of one year from January 2017 to December 2017. A total of 116 patients were included in this study. All breast lumps underwent surgery and the ultrasound findings of these lumps were compared with the histopathological findings. Data were collected from these patients by a preformed questionnaire and finally the data were analyzed. Results: Out of 116 patients only 21 cases were reported as malignant in ultrasound report but histopathology revealed 31 malignant patients. On histopathological examination 10 benign cases turned out to be malignant. Conclusion: The present study was undertaken to evaluate in diagnosing breast mass lesions individually by ultrasound and compared with histopathology for definitive management of a patient. Journal of Surgical Sciences (2019) Vol. 23 (1) : 10-12

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Hypofractionated radiotherapy for patients with locally advanced pancreatic cancer using tomotherapy Hi-Art and CyberKnife: A study of the treatment outcome and failure patterns.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.342 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 342-342

Author(s):

H. Jang

Keyword(s):

Pancreatic Cancer ◽

Treatment Outcome ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Locally Advanced Pancreatic Cancer ◽

Hypofractionated Radiotherapy ◽

Ulcer Bleeding ◽

Survival Duration ◽

Response Evaluation ◽

One Year

342 Background: To evaluate the treatment outcome and pattern of failure in the patients with locally advanced pancreatic cancer, who were treated with hypofractionated radiotherapy (RT) using TomoTherapy Hi-Art and Cyberknife. Methods: From April 2004 to May 2010, Twenty four patients with locally advanced pancreatic cancer received hypofractionated RT using TomoTherapy Hi-Art and Cyberknife at Seoul St. Mary's Hospital, the Catholic University of Korea. Eleven patients (45.8%) were treated using TomoTherapy Hi-Art and 13 patients (54.2%) using Cyberknife. The total dose delivered were 45∼55 Gy (median: 50 Gy) in 15∼22 fractions with TomoTherapy Hi-Art and 24∼40 Gy (median 30 Gy) in 3∼5 fractions with Cyberknife. The RECIST version 1.1 was used for the response evaluation. The follow-up duration was 3.0∼77.1 months (median: 34 months). Results: In the initial response evaluation, the rates of partial response, stable disease and progressive disease were 45.8%, 54.2% and 0%, respectively. Median survival duration was 11.1 months. One year and two year survival rates were 39.4% and 21.1%, respectively. Two patients (8.3%) had local failures and 11 patients (45.8%) had distant failures. Distant failures were main cause of failures. Median time to distant failures was 7.8 months and one year distant progression-free survival rate was 35.1%. The difference of the treatment outcome between TomoTherapy Hi-Art and Cyberknife was not statistically significant. Most patients experienced abdominal discomfort and pain after RT. However, no severe gastrointestinal complication such as ulcer, bleeding, perforation and fistula were noted. Conclusions: Hypofractionated RT for the patients with locally advanced pancreatic cancer showed excellent local control. However, overall survival still remains poor because of distant failures. Therefore, effective systemic chemotherapy should be considered with RT, either concurrently or sequentially. No significant financial relationships to disclose.

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What are the minimal standards of radiotherapy planning and dosimetry for “hypofractionated” radiotherapy in breast cancer?

The Breast ◽

10.1016/j.breast.2010.03.007 ◽

2010 ◽

Vol 19 (3) ◽

pp. 172-175 ◽

Cited By ~ 4

Author(s):

N. MacLeod ◽

A. McIntyre ◽

P.A. Canney

Keyword(s):

Breast Cancer ◽

Radiotherapy Planning ◽

Hypofractionated Radiotherapy

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Breast angiosarcoma one year after adenosquamous endometrial cancer — diagnostic pitfalls

Open Medicine ◽

10.2478/s11536-012-0088-7 ◽

2013 ◽

Vol 8 (1) ◽

pp. 52-55

Author(s):

Darko Zdravkovic ◽

Miroslav Granic ◽

Marija Zdravkovic ◽

Tomislav Randjelović ◽

Dragoljub Bilanović ◽

...

Keyword(s):

Endometrial Cancer ◽

Radical Hysterectomy ◽

Radiation Treatment ◽

Radical Mastectomy ◽

Outer Quadrant ◽

Angiosarcoma Of The Breast ◽

One Year ◽

The Right ◽

Postmenopausal Female ◽

Diagnostic Pitfalls

AbstractAngiosarcoma of the breast is a rare and very aggressive tumors originated from endothelial cells lining blood vessels. We report a case of a 55-year-old postmenopausal female with a primary breast angiosarcoma diagnosed just a one year after radical hysterectomy and radiation therapy due to endometrial cancer. The patient initially presented with postmenopausal bleeding. Cytology and biopsy of the endometrium were performed and endometrial adenosquamous carcinoma was diagnosed followed by radical hysterectomy and postoperative local radiatiotherapy (50 Gy). One year later patient presented with a great painful tumorous mass in the right breast. Physical examination revealed an oval tumor, located in upper and outer quadrant of the right breast, around 15 cm in diameter. Mammography and ultrasonography were performed. The angiosarcoma of the breast was confirmed by biopsy. The patient underwent radical mastectomy. Histopathology proved the diagnosis of angiosarcoma (high-grade, numerous mitoses over 10/10 HPF, necrosis, “blood lakes”, infiltrative borders). Differential diagnosis of a breast angiosarcoma should be considered in all painful breast tumours no mather the time and the location of the previous radiation treatment even if benign characteristics of these masses have been detected by mammography and breast ultrasound.

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Breast carcinoma en Cuirasse - case report

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.20131926 ◽

2013 ◽

Vol 88 (4) ◽

pp. 608-610 ◽

Cited By ~ 4

Author(s):

Gabriela Mantovanelli de Oliveira ◽

Daniele Bueno Carvalho Zachetti ◽

Hugo Rocha Barros ◽

Adriana Tiengo ◽

Ney Romiti

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Cutaneous Metastasis ◽

Contralateral Breast ◽

Skin Involvement ◽

Breast Volume ◽

Invasive Ductal Breast Carcinoma ◽

Skin Infiltration ◽

One Year ◽

The Right

Cutaneous metastasis is a phenomenon that results from a tumor spreading via lymphatic or vascular embolization, direct implant during surgery or skin involvement by contiguity. The primary malignant tumor that most commonly metastasizes to the skin in women is breast cancer, which can be manifested through papulonodular lesions, erysipeloid or sclerodermiform infiltration, en cuirasse. We report the case of a female patient, 78 years old, with papular, scaly and confluent lesions in the right breast for one year, progressing to edema and skin infiltration, reduction of breast volume and plaque en cuirasse, and similar lesions in the contralateral breast and abdomen for four months. The pathological diagnosis was invasive ductal breast carcinoma with Paget-like foci, epidermal skin metastases and lymphatic embolization.

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Evaluation of Clinicopathological Findings and Postoperative Outcomes of Modified Radical Mastectomy in a Tertiary Care Center in Lahore, Pakistan

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v10i2.634 ◽

2021 ◽

Vol 10 (2) ◽

pp. 89-94

Author(s):

Usman Ali Rahman ◽

Khalil Ahmad ◽

Umair Nazir ◽

Shabbar Hussain Changazi ◽

Ayesha Choudary ◽

...

Keyword(s):

Breast Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Hospital Stay ◽

Ductal Carcinoma ◽

Radical Mastectomy ◽

Modified Radical Mastectomy ◽

Clinicopathological Findings ◽

Duration Of Surgery ◽

The Mean ◽

One Year

Background: Modified radical mastectomy (MRM) remains the mainstay of breast cancer surgery in under-developed countries like Pakistan as it reduces the morbidity and mortality associated with radical surgery. This study aims to delineate the clinicopathological findings and postoperative outcomes of patients undergoing modified radical mastectomy for breast carcinoma in a local setting.Material and Methods: This cross-sectional study was conducted in Gulab Devi hospital Lahore, Punjab Pakistan, from January 2016 to December 2019. Patients (n=70) with carcinoma breast planned for modified radical mastectomy were included in the study. Two suction drains were placed (in the axilla and under the flap) and removed when drainage was less than 30 cc in 24 hours. The patients were followed-up weekly for one month and then at monthly intervals for up to one year. Independent t-test and chi-square test were used to study associations between different variables. A P-value less than .05 was considered statistically significant.Results: The mean age of the patients was 48.43 ± 12.3 years. Most of the patients (42.86%) had stage-II, grade-I carcinoma (50%) with invasive ductal carcinoma as the most frequent histological variety (80%). Majority of the patients (n=60; 85.57%) were ER/PR positive. Mean duration of surgery was 124.8 ± 20.33 minutes, the mean duration of drains was 3.5±4.5 days, and the mean length of hospital stay was 4.67 ± 1.07 days. Most common complications of mastectomy were wound infection (23.57%) and seroma formation (20%). Six (8.57%) developed recurrence of disease in one year follow-up. Neoadjuvant chemotherapy increased the mean duration of surgery and drains placement (P<.05) but had no effect on mean hospital stay and complications associated with surgery (P>.05).Conclusions: Grade-I invasive ductal carcinoma with ER/PR positive receptor status was the most frequent variety of breast carcinoma. Neoadjuvant chemotherapy was associated with increased operative time and increased duration of drain placement.

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Invasive papillary carcinoma of the breast: a rare case report

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00626-7 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Pratibha Issar ◽

M. Ravindranath ◽

Manish Dewangan

Keyword(s):

Papillary Carcinoma ◽

Rare Case ◽

Radical Mastectomy ◽

Myoepithelial Cells ◽

Left Breast ◽

Good Prognosis ◽

Menopausal Women ◽

Malignant Breast ◽

Post Menopausal ◽

Invasive Papillary Carcinoma

Abstract Background Invasive Papillary Carcinomas (IPC) are rare and account for approximately 0.5% of all invasive breast carcinomas. Most of them are seen in post-menopausal women and have a good prognosis. These tumors lack the myoepithelial cell layer (MCL) within the papillae or at the periphery of the tumor with areas showing stromal invasion or invasion into lymphovascular spaces. Immunohistochemistry (IHC) for myoepithelial cells and basement membrane is essential for the diagnosis of invasive cancer. Case presentation We present a rare case of IPC in a 74-year-old woman who presented with complaints of gradually increasing painless retroaerolar mass in the left breast of two months duration. The mass was irregular, having an oblong as well an adjacent high density mass lesion on mammography. Ultrasound (US), and Magnetic Resonance Imaging (MRI) helped in the diagnosis of the possibility of a malignant breast lesion. Left-sided modified radical mastectomy was performed and the specimen was histopathologically diagnosed as Invasive Papillary carcinoma. Immunohistochemistry confirmed the diagnosis. Conclusions Invasive Papillary Carcinomas of the breast are rare cancers in post-menopausal women. We have highlighted the role of Mammography, US, and MRI in early diagnosis so that timely management is possible.

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Spectrum of breast diseases in a rural himalayan region of Western Nepal: a hospital based study

Journal of Chitwan Medical College ◽

10.3126/jcmc.v10i3.32062 ◽

2020 ◽

Vol 10 (3) ◽

pp. 95-97

Author(s):

Harihar Devkota ◽

Suryaman Menyangbo ◽

Kapil Amgain

Keyword(s):

Health Sciences ◽

Breast Diseases ◽

Age Group ◽

Breast Abscess ◽

Fibrocystic Disease ◽

Benign Diseases ◽

The Third ◽

Malignant Breast ◽

One Year ◽

Benign Disorders

Background: Breast diseases, among the most common diseases in females occur in various patterns from benign to malignant. Their identification is crucial as some of the benign disorders pose threat to turn into malignancy. This study was aimed to determine the spectrum of breast diseases. Methods: This was a hospital based retrospective study among all the patients in General Surgery OPD of Karnali Academy of Health Sciences, Teaching Hospital, diagnosed with breast diseases during one year period from August 2019 to July 2020 AD. Data were extracted and entered in SPSS version 16 for further analysis. Results: Out of 110 cases, only 4 (3.96%) were male. Almost half 54 (49.09%) of the cases were in the age group of 21-30 years. Fibrocystic disease, Breast Abscess and fibroadenoma, and cracked nipple were 39 (35.45%), 38 (34.54%, 15 (13.63%) and 8 (7.28%) respectively. The benign diseases were seen mostly in the younger population while malignant breast diseases were seen in the older population. Mastalgia was mostly seen in the twenties (17.3%) and the thirties (10%) while Breast abscess was commonly encountered in the twenties (16.4%) and the teens (11.8%). The gynaecomastia were seen only in four males. Conclusions: Fibrocystic breast diseases, Mastitis with or without abscess, fibroadenoma and cracked nipples were the first four most common breast diseases in females. The younger population had predilection towards the benign diseases which occurred most frequently in the third decade while the malignant occurred in sixth and seventh decade.

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CRANIOSTENOSIS

PEDIATRICS ◽

10.1542/peds.30.1.57 ◽

1962 ◽

Vol 30 (1) ◽

pp. 57-70 ◽

Cited By ~ 1

Author(s):

John Mark Freeman ◽

Shirley Borkowf

Keyword(s):

Cosmetic Results ◽

Detectable Difference ◽

One Year ◽

The Brain

Thirty-four cases of craniostenosis are presented. Of the 19 cases of sagittal stenosis, 14 were unoperated. Four of these patients were retarded. This retardation was not believed to be caused by the craniostenosis. Of the five operated patients, three were seen at follow-up, and one was retarded. There was no difference in cosmetic results between the operated and unoperated cases. In the four cases of coronal stenosis there was no detectable difference in mental or cosmetic results between the operated and unoperated cases. In the combined stenosis group of 11 cases, four persons developed papilledema. There was no difference in mental or cosmetic results between those operated on before one year of age and those operated on when symptoms became evident. There is evidence to suggest that in sagittal and coronal stenosis growth of the brain is not restricted by closure of the suture. It would thus seem that there is little need for prophylactic operations but that instead operations should be performed only for papilledema or very severe deformity.

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