Timing of Surgical Management of Papillary Thyroid Cancer Diagnosed during Pregnancy

BACKGROUND AND OBJECTIVES: Although the thyroid cancer occurs in every one of 1000 pregnant women, the optimal timing of surgery is still uncertain. The aim of this study is to propose the timing of surgical management of papillary thyroid cancer in pregnant woman. MATERIALS AND METHODS: The authors reviewed the medical records of papillary thyroid cancer patients diagnosed during pregnancy in our hospital from May 1st, 2013 to April 30th, 2015. We analyzed the changes of radiologic and pathologic findings during prenatal and postpartum period. RESULTS: 17 of 4978 patients were diagnosed with papillary thyroid cancer. 10 of 17 patients enrolled in this study. Each size of thyroid cancer in 1st trimester, in 2nd trimester, in 3rd trimester, and after delivery was 11.30±6.01 mm, 12.74±7.79 mm, 13.82±9.93 mm, and 13.82±8.19 mm, respectively. No patient showed the recurrence or death after surgery. CONCLUSION: There was no statistical significance on the prognosis of papillary thyroid cancer during prenatal and postpartum period. The authors propose that the surgical treatment of papillary thyroid cancer diagnosed during pregnancy could be delayed after delivery.

Timing of Surgical Management of Papillary Thyroid Cancer Diagnosed during Pregnancy

BACKGROUND AND OBJECTIVES: Although the thyroid cancer occurs in every one of 1000 pregnant women, the optimal timing of surgery is still uncertain. The aim of this study is to propose the timing of surgical management of papillary thyroid cancer in pregnant woman. MATERIALS AND METHODS: The authors reviewed the medical records of papillary thyroid cancer patients diagnosed during pregnancy in our hospital from May 1st, 2013 to April 30th, 2015. We analyzed the changes of radiologic and pathologic findings during prenatal and postpartum period. RESULTS: 17 of 4978 patients were diagnosed with papillary thyroid cancer. 10 of 17 patients enrolled in this study. Each size of thyroid cancer in 1st trimester, in 2nd trimester, in 3rd trimester, and after delivery was 11.30±6.01 mm, 12.74±7.79 mm, 13.82±9.93 mm, and 13.82±8.19 mm, respectively. No patient showed the recurrence or death after surgery. CONCLUSION: There was no statistical significance on the prognosis of papillary thyroid cancer during prenatal and postpartum period. The authors propose that the surgical treatment of papillary thyroid cancer diagnosed during pregnancy could be delayed after delivery.

Diagnostic Effectiveness of USPIO versus Gadolinium Based MRI for Axillary Metastasis in Breast Cancer: A Meta-analysis

PURPOSE: This report compared the diagnostic effectiveness between ultrasmall superparamagnetic iron oxide (USPIO) and gadolinium (Gd) based magnetic resonance imaging (MRI) for differentiation of axillary status in breast cancer patients. MATERIALS AND METHODS: The present authors performed a meta-analysis of previous studies that compared USPIO or Gd based MRI with histological diagnosis after surgery or biopsy. We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, Ovid databases and references of articles to identify studies reporting data until December 2013. Pooled sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analysis was done. Analyses of study quality and heterogeneity were also assessed. RESULTS: There were 14 publications that met the criteria for inclusion in our metaanalysis. USPIO based MRI showed 0.83 (95% CI: 0.75-0.89) and 0.97 (95% CI: 0.94-0.98) for pooled sensitivity and specificity, respectively. Gd based MRI represented pooled sensitivity and specificity of 0.61 (95% CI: 0.55-0.67) and 0.90 (95% CI: 0.87-0.92) for each. Overall weighted area under the curve for USPIO and Gd based MRI were 0.9563 and 0.9051, respectively. CONCLUSION: USPIO based MRI had a tendency toward high pooled sensitivity and specificity in detection of axillary metastases for breast cancer. This result may mean that USPIO based MRI could be used as complementary modality to differentiate axillary status more precisely, and assist in the decision-making process regarding possible invasive procedures, such as sentinel node biopsy.

Influence of Androgen Receptor Expression on the Survival Outcomes in Breast Cancer: A Meta-Analysis / 한국유방암학회지

PURPOSE: Despite the fact that the androgen receptor (AR) is known to be involved in the pathogenesis of breast cancer, its prognostic effect remains controversial. In this meta-analysis, we explored AR expression and its impact on survival outcomes in breast cancer. METHODS: We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, and Ovid databases and references of articles to identify studies reporting data until December 2013. Disease-free survival (DFS) and overall survival (OS) were analyzed by extracting the number of patients with recurrence and survival according to AR expression. RESULTS: There were 16 articles that met the criteria for inclusion in our meta-analysis. DFS and OS were significantly longer in patients with AR expression compared with patients without AR expression (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.40-0.90; OR, 0.53; 95% CI, 0.38-0.73, respectively). In addition, hormone receptor (HR) positive patients had a longer DFS when AR was also expressed (OR, 0.63; 95% CI, 0.41-0.98). For patients with triple negative breast cancer (TNBC), AR expression was also associated with longer DFS and OS (OR, 0.44, 95% CI, 0.26-0.75; OR, 0.26, 95% CI, 0.12-0.55, respectively). Furthermore, AR expression was associated with a longer DFS and OS in women (OR, 0.42, 95% CI, 0.27-0.64; OR, 0.47, 95% CI, 0.38-0.59, respectively). However, in men, AR expression was associated with a worse DFS (OR, 6.00; 95% CI, 1.46-24.73). CONCLUSION: Expression of AR in breast cancer might be associated with better survival outcomes, especially in patients with HR-positive tumors and TNBC, and women. Based on this meta-analysis, we propose that AR expression might be related to prognostic features and contribute to clinical outcomes.