ABSTRACT
This study aimed to compare the efficiency of isosulfan blue [ISB] and colloid methods in determining metastatic conditions of axillary lymph node in sentinel lymph node biopsy [SLNB]. This prospective study was performed between April 2005 and July 2009 at Gulhane Medical Faculty, Department of General Surgery. A total of 102 female patients diagnosed with breast cancer were enrolled in the clinic of Gulhane School of Medicine. According to the diagnostic protocols of SLN, the patients were divided into three groups as follows: ISB [group I], colloid [group II], and ISB and colloid [group III]. SLN was identified in 49 of 52 patients [94.2%] in the ISB group; the sensitivity, specificity, negative predictive value [NPV], positive predictive value [PPV], and false negativity [FN] ratio were found to be 90.9%, 75.8%, 96.1%, 55.5%, and 9.1%, respectively. On the contrary, the sentinel lymph node was identified in 38 of 38 [100%] patients in the colloid group; the sensitivity, specificity, PPV, NPV, and FN were found to be 88.2%, 100%, 100%, 91.3%, and 11.8%, respectively. In ISB and colloid groups; SLN was identified in 12 of 12 [100%] patients in the ISB and colloid groups; the sensitivity, specificity, PPV, NPV, and FN were found to be 100%, 100%, 100%, and 0%, respectively. This study showed that the combined methods applied to heterogeneous groups of patients for SLNB in breast cancer cases were minimally invasive and effective and hence could be used for evaluating nodal metastases
ABSTRACT
To discuss the clinical and radiological features and treatment approaches in 14 patients diagnosed with idiopathic granulomatous mastitis [GM]. We retrospectively evaluated the clinical features, radiological findings, and treatment approaches in 14 patients with idiopathic GM in the General Surgery Department, Gulhane School of Medicine, Ankara, Turkey between April 2000 and June 2006. The mean age of the patients was 34.5 years [range 27-41 years]. The complaints at admission were a mass in the breast in 7 [50%] patients, an abscess and a mass in 6 [42.8%], and a skin fistula in one [7.2%]. Granulomatous mastitis was unilateral in all subjects [on the right in 5 patients and on the left in 9]. All of the patients underwent ultrasonographic evaluation. Mammography was performed in 8 and magnetic resonance imaging in 5 patients. Seven patients [50%] were suspected to have breast carcinoma according to radiological findings. We performed large excision in 11, incisional biopsy plus abscess drainage in one, and incisional biopsy plus abscess drainage plus medical treatment [prednisolone, methotrexate] in 2 patients. Due to the development of abscess after 9 months, drainage and large excision were also performed in one patient who received medical treatment. Idiopathic GM is a disease that generally affects young women of reproductive age and may be mistaken for breast carcinoma in clinical and radiological evaluations. The gold standard for the diagnosis is histopathologic evaluation