A prospective study on the quality of life after palliative surgery for patients with advanced breast or gastrointestinal malignancies

OBJECTIVE: To evaluate the quality of life (QoL) after palliative surgery of patients with advanced breast or gastrointestinal malignanciesMETHODS: Quality of Life (QoL) of 32 patients with advanced breast or gastrointestinal cancer (Stage IIIB up to Stage IV) was evaluated before surgery (baseline), then 7 and 30 days after surgery using the Medical Outcomes Study Short form (SF-36v2? Questionnaire).Statistical significance of the difference in outcomes was tested using the two-tailed T-test at 95% CI.RESULTS: Preoperatively, the patients scored poorly (scores below the average mean of 50) in all 8 subscales of the SF-36v2?. Seven days after a palliative surgery, patients showed significant improvement in all subscales except Vitality and Social Functioning.The patients experienced statistically significant changes in quality of life subscale scores on Physical Functioning, Role-Physical, Bodily Pain, General Health, Role Emotional, and Mental Health after surgery. A significant change in all subscales occurred 30 days after surgery compared to the baseline and 7 days post-op.CONCLUSIONS: While patients with advanced malignancy experienced problems with quality of life preoperatively, they improved postoperatively but not to the level of a normal person.

Sentinel lymph node biopsy using methylene blue dye - the Vicente Sotto Memorial Medical Center experience

Objectives: To determine the accuracy of SLNB using methylene blue dye. Methods: Breast cancer patients consulting at the VSMMC Breast Center with biopsy proven adenocarcinoma of the breast, a Tis, T1, T2 or T3 primary breast tumor and clinically negative ipsilateral axilla by palpation and ultrasound, were included in the study. The subjects underwent either modified radical mastectomy or breast conservation theraphy. Subareolar injection of 5 ml 1% methylene blue dye 5 minutes prior to sentinel lymph node biopsy. Three blue staining axillary lymph nodes were taken and sent to pathology for frozen section evaluation and after surgery, H & E staining. A completion axillary lymph node dissection was done in all patients. Accuracy of SLNB using methylene blue was calculated using final histopathology results as gold standard. Results: Twent patients were included in this study. SLNB in this group had an accuracy, sensitivity, specificity, PPV, and NPV of 95.0% 83.3%, 100%, 100%, and 93.3%, respectively. The false negative rate is 6.7%. On the average, the SLN's were identified in 14 minutes. Conclusion: Sentinel lymph node dissection with methylene blue has an accuracy of 95% in the VSMMC Breast Center. Key words: sentinel lymph node biopsy, methylene blue dye, breast cancer

The accuracy of combination ultrasound and fine needle aspiration biopsy in confirming malignancy in patients with clinically malignant breast masses seen at the breast center of Vicente Sotto Memorial Medical Center

Objectives: To determine if ultrasound can increase the accuracy of fine needle aspiration biopsy in confirming malignancy in clinically malignant breast masses. Methods: Clinically malignant breast masses underwent ultrasound, fine needle aspiration biopsy/cytology, and tissue biopsy. Accuracy of each test and in combination were calculated using histopathology as gold standard. Results: The accuracy of ultrasound alone was only 67.5% sensitivity of 90.0%, specificity of 33.3%, positive predictive value of 67.2% and negative predictive value of 68.8%, while FNAB alone has an accuracy of 89.2%, sensitivity of 90.0%, specificity of 87.9%, postive predictive value of 91.8%, and negative predictive value of 85.3%. With concordant findings in ultrasound and FNAB, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value are 94.3%, 97.6%, 81.8%, 95.3%, and 90%, respectively. Conclusion: With concordant findings in ultrasound and FNAB, accuracy in confirming malignancy is 94.3%. Key words: breast cancer, breast ultrasonography, fine needle aspiration biopsy/cytology