ABSTRACT
Resumen:El carcinoma de mama representó el tumor en mujeres más frecuente en Costa Rica para el año 2013. La disección axilar en el cáncer de mama es una de las causas de mayor comorbilidad en las pacientes. La realización de un ganglio centinela para determinar si es necesario la disección axilar, ha resultado de gran ayuda, reduciendo las comorbilidades en las pacientes con cáncer de mama. La experiencia del cirujano en la realización de procedimiento y del patólogo, han reducido los falsos negativos en los ganglios centinelas por congelación hasta en un 4.5%.En este estudio se analizaron los ganglios centinelas por congelación que contaban con biopsia definitiva y se determinó que los falsos negativos para nuestro hospital eran del 1.2%, además en estos casos, se determinó la media de tipo histológico, el grado histológico y el tamaño del cáncer de mama. En conclusión, se determinó que una de las casusas principales asociadas a los falsos negativos es la presencia de tejido adiposo en el ganglio centinela.
AbstractBreast carcinoma represented de most frequent tumor in Costa Rica during 2013. The axillary dissection in pacients with breast cancer is one of the causes of the most frecuent comorbidity. Studying sentinel ganglion to decide if it is necesary to make an axillary dissection has become very useful in reducing comorbidity in pacients with breast cancer. The surgeon´s and de pathologist´s work experience with this procedure has reduced false positive results in the sentinel ganglion´s biopsies by frezzing method in 4,5%. During the current report the sentinel ganglions by freezing method that had a definite biopsy were studied and we arrived to the conclusion that for our hospital falsepositives were less than 1,2%. As well in this cases it was determined the histologic type, the histologic grade and the size of the breast cancer. In conclusion it was determined that one of the most frecuent causes associated with false positives is the presence of adipose tissue in the sentinel ganglion.
Subject(s)
Humans , Breast Neoplasms , Costa Rica , Sentinel Lymph Node Biopsy , False Positive Reactions , Sentinel Lymph Node , Lymph Node ExcisionABSTRACT
Introduction: Phyllodes tumors (PT) of the breast seem to get pre-operatively misdiagnosed as fibroadenomas resulting in inadequate resections and high local recurrence rates. Materials and Methods: Data of 150 patients with PT of the breast managed from January, 2003 to February, 2013 were retrospectively analyzed. Statistical analysis performed using SPSS version 17 (Pearson Chi-square test and analysis of variance test for analysis). Aim: The aim of this study is to compare clinico-pathological profile and recurrence rates in patients with benign (B), borderline malignant (BL) and malignant (M) PT. Results: In a total of 150 patients with PT (n = 77 B, n = 24 BL, n = 49 M), mean age was 36.92, 44.04 and 40.46 years respectively (P 0.015) and mean tumor size being 8.15 cm, 14.7 cm and 12.9 cm respectively (P 0.000). Pre-operatively cytology suggestive of PT in 24% patients with B PT and 63% in M PT; core tissue biopsy suggestive of PT in 85.4% patients with B PT and 100% in M PT. Recurrence seen in 34.7% out of which 32.7% were post-lumpectomy performed elsewhere. Majority of B PT had lumpectomy (49.3%)/wide local excision (WLE, 31.2%) compared with M PT where 55.1% had simple mastectomy (SM) due to large tumor size. Local recurrence was more in M PT (53%) compared with B PT (20%). We found recurrence rates in L (39.3%) compared with WLE (27.3%) and SM (33.9%) (P 0.049). Conclusions: Larger tumor size, incomplete resection and M/BL histology predicted higher recurrence in PT. Core biopsy is much more accurate than fine needle cytology in the diagnosis.