ABSTRACT
It is more than 60 years that Fine Needle Aspiration [FNA] has been used for diagnosing palpable breast masses and has been known as an effective method for several years in Europe. In this study, we compared the diagnostic accuracy of FNA with open biopsy in Tabriz and Shiraz, Iran. We studied 100 patients with breast lesions in Tabriz Imam Khomeini Hospital from late September 2003 to late July 2004. FNA and open biopsy were done for all patients, FNA results were studied by pathologists in Tabriz imam Khomeini hospital and Shiraz University and pathological and cytological results were compared. According to cytology, 44% of samples were benign, 15% were suspicious, 33% were malignant and 8% were insufficient in Tabriz. These figures were 25%, 10%, 27% and 37%, respectively in Shiraz. Sensitivity of FNA was higher in Tabriz [89.79% vs. 69%] but specificity did not differ significantly in two groups [93.47% vs. 80.95%]. Positive and negative predictive values were 97.77% and 89.36% in Tabriz and 100% and 60.6% in Shiraz, respectively. FNA accuracy was higher in Tabriz than in Shiraz [93.47% vs. 80.95%]. If done by experts, FNA can be a reliable replacement for open biopsy in palpable breast masses. Evaluation of FNA samples during aspiration can decrease insufficient samples. FNA [at least in deprived areas] can be the first line of diagnosis in women with breast masses and is helpful to increase health standards and clinical supervision of patients
Subject(s)
Humans , Female , Biopsy, Fine-Needle , Breast/pathology , Breast Neoplasms/pathology , BiopsyABSTRACT
With promising results from several institutions, many centers began to treat patients with esophageal squamous cell carcinoma [SCC] with neoadjuvant chemoradiotherapy followed by esophagectomy. The aim of this research is to determine the feasibility of this method in our selected patients. In this prospective phase I clinical trial, 10 patients [7 male, 3 female; 58.4 +/- 2.5 Y/O] with stage III and VIA lower thoracic esophageal SCC, were treated with intravenous infusion of 1000 mg/m[2]/day 5-flourouracil during day 1 to 4, 75 mg/m[2] cisplatin in day 1, and a total dose of 18 Gray external beam radiation during day 1 to 6 and underwent transhiatal esophagectomy during day 7 till 10. This group was compared with a retrospective group of 61 patients which treated with surgery alone. Age, sex, duration and grading of the dysphagea, differentiation and staging of the tumor were not different in these two groups. There is no complete pathologic response in the study group. One patient died because of severe leukopenia and sepsis and other because of azygos vein rupture. Other complications were: chylothorax which required later thoracotomy [10%], recurrent nerve paresis [10%], superficial wound infection of the neck incision [10%]. All patients had mild to moderate leukopenia [2600'400/mm3] during days 11 to 16. Total postoperative intensive care unit stay was 2.2 +/- 0.5 days and postoperative hospitalization was 15.7 +/- 1.8 days and in-hospital operative mortality was 20% and total morbidity was 50% which were not significantly different from control group [p<0.05]. Postoperative blood transfusion was 5.3 +/- 0.8 unit per patient which was significantly greater than control group[P<0.05]. The perioperative mortality and morbidity of this neoadjuvant protocol is acceptable comparing with our control group and we can propose phase II and III studies for determining the long-term effect of these protocol