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1.
Rev. colomb. cir ; 38(4): 624-631, 20230906. tab, fig
Article in Spanish | LILACS | ID: biblio-1509696

ABSTRACT

Introducción. El tejido mamario accesorio es una anomalía congénita que se presenta en el 2-6 % de la población femenina. En este tejido se pueden desarrollar las mismas patologías que en la mama normal. El manejo curativo es la resección quirúrgica. El objetivo de este estudio fue comparar los resultados de la técnica de resección vía abierta de tejido mamario accesorio con dren vs sin dren. Métodos. Se realizó un estudio observacional tipo cohorte retrospectivo, teniendo en cuenta dos grupos de pacientes con tejido mamario accesorio: a uno de ellos se les realizó resección quirúrgica mediante técnica abierta con dren y al otro grupo sin dren. Además, se incluyó un brazo prospectivo donde se evaluó la calidad de vida y la satisfacción de las pacientes con el resultado posoperatorio mediante el uso de la herramienta Breast-Q. Resultados. Se recolectó la información de 82 pacientes, la mayoría mujeres; 22 se intervinieron con técnica con dren y 60 con técnica sin dren. 13,6 % de los pacientes presentaron complicaciones tempranas, siendo la infección de sitio operatorio la más frecuente (36,4 %). En general, las complicaciones fueron más comunes en el grupo con dren (40,9 % vs 3,4 %), con una diferencia estadísticamente significativa (p=0,000). La calidad de vida fue similar en ambos grupos. Conclusiones. Los pacientes a quienes se les realizó resección de mama supernumeraria y se dejó un sistema de drenaje en el lecho de disección presentaron más complicaciones posoperatorias que las pacientes a quienes no se les dejó dren


Introduction. Accessory breast tissue is a congenital anomaly that occurs in 2-6% of the female population. It can develop the same pathologies that in the normal breast. The curative management of this pathology is surgical resection. The objective of this study was to compare the results of the accessory breast tissue open resection technique with a drain vs without a drain. Methods. An observational retrospective cohort study was conducted considering two groups of patients with accessory breast tissue: one of them underwent surgical resection using an open technique with a drain and the other group without a drain. In addition, a prospective arm where the quality of life and satisfaction of the patients with the postoperative result was evaluated by the Breast-Q tool. Results. Eighty-two patients were included, most of them women; 22 were operated with open technique with drain and 60 without drain. 13.6% of patients presented early complications, with surgical site infection being the most frequent (36.4%) and, in general, complications were more common in the group with drain (40.9% vs 3.4%) with a statistically significant difference (p=0.000). Quality of life was similar in both groups.Conclusions. Patients who undergo supernumerary breast resection and leaving drainage in the dissection bed present more postoperative complications compared to those without drain


Subject(s)
Humans , Postoperative Complications , Breast Diseases , Drainage , General Surgery , Breast , Choristoma
2.
J.health med.sci. ; 9(3): 75-82, jul.2023. graf
Article in Spanish | LILACS | ID: biblio-1524804

ABSTRACT

El objetivo de este estudio fue establecer y mantener activo un programa de control de calidad semanal en un sistema de mamografía digital de campo completo (FFDM) con tomosíntesis digital de mama (DBT) para optimizar la relación dosis-calidad de imagen en el tamizaje mamográfico y en el diagnóstico de las patologías de la mama, así como determinar la sensibilidad y especificidad en el periodo 2019-2022. Las imágenes mamográficas fueron obtenidas con el maniquí del Colegio Americano de Radiología (ACR) como parte del programa de control de calidad y con el uso de un dosímetro se determinó la dosis glandular media (DGM). También se midieron otras variables que afectan calidad de imagen y dosis. La imagen optimizada tiene el potencial de reducir la tasa de mortalidad por cáncer de mama debido a que el cáncer de mama es un problema de salud pública en los países en vías de desarrollo. Los resultados generales en el periodo del estudio se ilustran con graficas e intervalos de confianza al 95% (IC, 95%), además los valores numéricos se expresan en términos del error estándar de la media con 95% de confianza. Para mamografía digital de campo completo (FFDM): mAs = 160 ± 3.74, kVp = 28, dosis glandular media (DGM) = 1.69 ± 0.02 mGy, razón señal-ruido (SNR) = 62.20 ± 0.67, razón contraste-ruido (CNR) = 12.16 ± 0.15 y para tomosíntesis digital de mama (DBT): mAs = 61.42 ± 1.14, kVp = 29, dosis glandular media (DGM) = 1.54 ± 0.01 mGy. Los valores de las diferentes variables fueron determinados de acuerdo a la metodología del fabricante (Hologic, 2011). Los valores de la sensibilidad y la especificidad fueron para mamografía digital de campo completo (FFDM) sensibilidad 91% y especificidad 94% y para tomosíntesis digital de mama (DBT) sensibilidad 94% y especificidad 97%. Los resultados de dosis y calidad de imagen en ambas modalidades mamografía digital de campo completo (FFDM) y tomosíntesis digital de mama (DBT) muestran que el programa de control de calidad se mantuvo operativo durante el estudio manteniendo una relación optimizada entre dosis y calidad de imagen


The objective of this study was to establish and maintain active a weekly quality control program in a full-field digital mammography (FFDM) system with digital breast tomosynthesis (DBT) to optimize the dose-image quality relationship in mammographic screening and in diagnosis of breast pathologies, as well as determining sensitivity and specificity in the period 2019-2022. Mammographic images were obtained with the American College of Radiology (ACR) phantom as part of the quality control program and the mean glandular dose (DGM) was determined with a dosimeter. Other variables that affect image quality and dose were also measured. Optimized imaging (image quality-dose) has the potential to reduce the breast cancer mortality rate because breast cancer is a public health problem in developing countries. The general results in the study period are illustrated with graphs and 95% confidence intervals (CI, 95%), in addition the numerical values are expressed in terms of the standard error of the mean with 95% confidence, For full field digital mammography (FFDM): mAs = 160.3 ± 3.74, kVp = 28, mean glandular dose (DGM) = 1.69 ± 0.02 mGy, signalto-noise ratio (SNR) = 62.20 ± 0.67, contrast-to-noise ratio (CNR) = 12.16 ± 0.15 and for tomosynthesis digital breast (DBT): mAs = 61.42 ± 1.14, kVp = 29, mean glandular dose (DGM) = 1.54 ± 0.01 mGy. The values of the different variables were determined according to the manufacturer's methodology. Mammography facility sensitivity and specificity values were determined using pathology results during the study. For FFDM mode they were sensitivity 91% and specificity 94% and for DBT mode they were sensitivity 94% and specificity 97%. The dose and image quality results in both full field digital mammography (FFDM) and digital breast tomosynthesis (DBT) modalities show that the quality control program remained operational during


Subject(s)
Breast Neoplasms/diagnostic imaging , Mammography/instrumentation , Mammography/methods , Radiation Dosage , Breast Diseases/diagnostic imaging , Radiographic Image Enhancement/methods
3.
Rev. bras. ginecol. obstet ; 45(6): 319-324, June 2023. tab, graf
Article in English | LILACS | ID: biblio-1449745

ABSTRACT

Abstract Objective Reporting our experience of the management and treatment of Idiopathic granulomatous mastitis (IGM) in a low-income country by describing patients characteristics and therapy with emphasis on conservative surgical excision and postoperative care as the cornerstone of treatment. Methods A retrospective cohort of women with histopathological diagnosis of IGM from 2014 to 2018 at Instituto Nacional Materno Perinatal in Lima, Peru. Patients' characteristics, clinical presentation, treatment, management, postoperative care, and follow-up were analyzed. Results Thirty-eight patients with histopathological diagnosis of IGM were identified. Their average age was 35.9 years and 23 (60.5%) reported previous use of hormonal contraceptives. Nine (23.7%) patients had chronic mastitis with previous treatment. The time from the onset of symptoms to the first clinic consult was 5.1 months on average. Twenty-one (55.3%) patients had the lesion in the right breast, with a mean size of 6.9 cm. Conservative surgical excision was performed in all patients. Additionally, 86.8% required corticosteroids and 78.9% were treated with antibiotics. Complete remission was obtained at 141 days on average (range 44 to 292 days). Six (15.8%) women reported ipsilateral recurrence and 5 (13.2%), contralateral. The latency time was 25.5 months on average. Conclusion The conservative surgical treatment demonstrated and close follow-up made for a high cure rate, but with recurrence similar to that reported in the literature. Use of gloves is an alternative to manage post operative wounds in a low-income country. The most frequent adverse effect was breast surgical scar.


Subject(s)
Humans , Female , Recurrence , Breast Diseases , Breast Diseases/surgery , Adrenal Cortex Hormones , Granulomatous Mastitis/therapy
4.
FEMINA ; 51(4): 228-232, 20230430.
Article in Portuguese | LILACS | ID: biblio-1512396

ABSTRACT

PONTOS-CHAVE As lesões mamárias compreendem uma ampla variedade de diagnósticos que apresentam comportamentos diversos. As lesões mamárias podem ser classificadas como lesões benignas, de potencial de malignidade indeterminado (B3), carcinoma in situ e carcinoma invasor. Na era da medicina personalizada, individualizar e obter um diagnóstico preciso faz grande diferença no desfecho final da paciente, principalmente no caso do câncer de mama. Exames de imagem direcionados e de qualidade, métodos de biópsia adequadamente selecionados e análises de anatomopatologia convencional, imuno-histoquímica e até molecular são determinantes no diagnóstico e no manejo das pacientes.


Subject(s)
Humans , Female , Breast Diseases/diagnosis , Breast Neoplasms/diagnosis , Molecular Diagnostic Techniques/instrumentation , Axilla/diagnostic imaging , Immunohistochemistry/methods , Magnetic Resonance Imaging/methods , Mammography , Mammary Glands, Human/diagnostic imaging , Cell Biology
5.
Article in Spanish | LILACS, BDENF, CUMED | ID: biblio-1508169

ABSTRACT

Introducción: Las complicaciones mamarias relacionadas con la lactancia materna suelen aparecer entre el primer y el décimo día posparto, las cuales pueden provocar lesiones en la salud de la mujer y en el destete precoz. Por lo tanto, la acción de la enfermera frente a estas condiciones es de gran importancia social. Objetivo: Comprender la actuación de enfermería ante complicaciones mamarias relacionadas con la lactancia materna. Métodos: Estudio descriptivo con enfoque cualitativo basado en la Teoría de las Representaciones Sociales, realizado con 17 enfermeras que trabajan en las 29 Unidades de Salud de la Familia del municipio de Porto Seguro, Bahía, Brasil, en el período de febrero a junio de 2021. Como técnica de recolección de datos, se utilizó la entrevista guiada por un guion semiestructurado. Los datos empíricos se analizaron mediante el análisis de contenido temático propuesto por Bardin. Resultados: Los resultados obtenidos tras el análisis fueron interpretados y apoyados en la Teoría de las Representaciones Sociales, que permitió la construcción de la categoría: Praxis de las enfermeras frente a las complicaciones mamarias. La categoría demostró que el conocimiento de las enfermeras sobre las complicaciones mamarias es insuficiente para anclar la práctica del cuidado. Conclusión: El conocimiento de las enfermeras sobre las complicaciones mamarias relacionadas con la lactancia materna demostró ser insuficiente para ofrecer prácticas asistenciales eficaces y actualizadas, necesarias para una actuación adecuada y que favorezcan el mantenimiento de la lactancia materna durante el tratamiento, por lo que se requiere educación permanente sobre el tema.


Introduction: Breast complications related to breastfeeding usually appear between the first and tenth postpartum day. They may appear with lesions to women's health and early weaning. Therefore, the nurse's action in the face of these conditions is of great social importance. Objective: To understand the nursing action in the face of breast complications related to breastfeeding. Methods: A descriptive study with a qualitative approach and based on the social representations theory was conducted with 17 nurses working in the 29 family health units of Porto Seguro Municipality, Bahia State, Brazil, in the period from February to June 2021. The used data collection technique was the interview guided by a semistructured script. The empirical data were analyzed using the thematic content analysis proposed by Bardin. Results: The results obtained after the analysis were interpreted and supported by the social representations theory, which allowed the construction of the category praxis of nurses in the face of breast complications. The category showed that the nurses' knowledge about breast complications is insufficient to anchor the practice of care. Conclusion: The nurses' knowledge about breast complications related to breastfeeding proved to be inept to offer effective and updated care practices, necessary for an adequate performance and favoring the maintenance of breastfeeding during treatment; therefore, permanent education on the subject is required.


Subject(s)
Humans , Female , Breast Diseases/complications , Breast Feeding/adverse effects , Nursing Care/methods , Maternal and Child Health
6.
Ann. afr. méd. (En ligne) ; 16(2): 5058-5066, 2023. tables
Article in French | AIM | ID: biblio-1425738

ABSTRACT

Contexte et objectif. Malgré leur fréquence élevée, très peu d'études ont été menées sur les tumeurs bénignes du sein (TBS) en Afrique subsaharienne. L'objectif de la présente étude a été d'évaluer la valeur diagnostique des explorations clinique et échographique mammaire des TBS en milieu peu équipé. Méthodes. Il s'agissait d'une étude documentaire, sur les TBS suivies aux Cliniques Universitaires de Kinshasa, entre janvier 2016 et décembre 2021. La valeur diagnostique des explorations clinique et échographique mammaire des TBS (sensibilité, spécificité, valeur prédictive négative VPN, VPP, coefficient Kappa) a été calculée en prenant pour référence la découverte anatomopathologique des pièces biopsiques. Résultats. Au total, 81 dossiers de TBS ont été colligés. Le Fibroadénome 58 (71,6 %), la Maladie fibrokystique (MFK) 15 (18,5 %), l'Adénome tubuleux 6(7,4 %), la Tumeur Phyllode (TP) 1(1,2 %) et le kyste 1(1,2 %) étaient les tumeurs diagnostiquées à l'anatomopathologie, après tumorectomies. A l'examen clinique, la capacité diagnostique des TBS autres que le Fibroadénome était nulle. La spécificité, la VPN et le coefficient kappa étaient respectivement, de 60,0 %, 39,1 % et 32,2 % pour le diagnostic du Fibroadénome. L'échographie mammaire était faite dans 98,6 % tandis que la mammographie seulement dans 11,1 % des cas. La majorité des tumeurs étaient classées Breast Imaging reporting and Data system (BIRADS) 2 (70,0 %). La spécificité, la VPN et le coefficient kappa étaient respectivement, de 80,6 %, 40,9 % et 39,0 % pour le Fibroadénome, et de 84,4 %, 66,7 % et 1,9 % pour la MFK. La TP était classée BIRADS3. Conclusion. L'échographie mammaire très réalisée, est très performante dans la classification BIRADS des TBS; les cliniciens exerçant en milieu peu équipé peuvent donc sans équivoque suivre les recommandations sur la prise en charge des tumeurs classées BIRADS2 et BIRADS3 à l'échographie, bien que sa performance en ce qui concerne le diagnostic différentiel de ces tumeurs soit moindre.


Subject(s)
Humans , Brain Neoplasms , Breast Diseases , Diagnostic Services , Breast Neoplasms , Ultrasonography, Mammary , Medical Laboratory Personnel
7.
Cambios rev med ; 21(2): 878, 30 Diciembre 2022.
Article in Spanish | LILACS | ID: biblio-1415283

ABSTRACT

INTRODUCCIÓN. La mastitis granulomatosa idiopática es una patología inflamatoria benigna de mama con clínica y hallazgos imagenológicos no específicos; usualmente confundida con cáncer de mama. El síntoma más frecuente es una masa mamaria palpable. El diagnóstico es histopatológico. OBJETIVO. Describir el perfil demográfico, presentación clínica y hallazgos radiográficos de pacientes con diagnóstico histopatológico de mastitis granulomatosa idiopática. MATERIALES Y MÉTODOS. Estudio observacional, descriptivo, retrospectivo. Población de 1130 y muestra de 49 datos de historias clínicas electrónicas de pacientes con diagnóstico histológico de mastitis granulomatosa idiopática con el código CIE10 N61x Trastornos Inflamatorios de la mama, atendidas en la Unidad Técnica de Imagenología del Hospital de Especialidades Carlos Andrade Marín en la ciudad de Quito entre enero 2019 hasta diciembre 2021. El criterio de inclusión fue la confirmación histopatológica de mastitis granulomatosa idiopática. Los criterios de exclusión: antecedentes de neoplasia maligna de mama, antecedentes de HIV, patología inflamatoria sistémica como granulomatosis de Wegener, sarcoidosis, infecciones granulomatosas crónicas como tuberculosis, brucelosis, histoplasmosis, sífilis y reacciones a cuerpos extraños como material de implantes mamarios. Se analizaron datos demográficos, presentación clínica, hallazgos mamográficos, ecográficos y la categorización BIRADS. Se efectuó un análisis univarial; para las variables cualitativas se realizó frecuencias y porcentajes; para las variables cuantitativas se realizó medidas de tendencia central. La información recolectada fue analizada en el programa estadístico International Business Machines Statistical Package for the Social Sciences. RESULTADOS La mediana de la edad fue 36 años. El 94,00% de pacientes tenían por lo menos un hijo; 77,50% presentaron con una masa palpable; 55,10% se acompañaron de signos inflamatorios; 16,00% asociaron fístulas y 24,40% presentaron secreción. Solo 1 caso presentó afectación bilateral. CONCLUSIÓN En este estudio, la mastitis granulomatosa idiopática afecta a mujeres en edad reproductiva sin antecedentes de malignidad quienes presentan una masa mamaria palpable que puede estar acompañada de signos inflamatorios, colecciones y fístulas. La realización de una biopsia core eco guiada, para confirmar su diagnóstico.


INTRODUCTION. Idiopathic granulomatous mastitis is a benign inflammatory breast pathology with nonspecific clinical and imaging findings; usually mistaken for breast cancer. The most frequent symptom is a palpable breast mass. The diagnosis is histopathologic. OBJECTIVE. To describe the demographic profile, clinical presentation and radiographic findings of patients with histopathologic diagnosis of idiopathic granulomatous mastitis. MATERIALS AND METHODS. Observational, descriptive, retrospective study. Population of 1130 and sample of 49 data from electronic medical records of patients with histological diagnosis of idiopathic granulomatous mastitis with ICD10 code N61x Inflammatory disorders of the breast, attended at the Technical Imaging Unit of the Carlos Andrade Marín Specialties Hospital in the city of Quito between January 2019 and December 2021. The inclusion criterion was histopathological confirmation of idiopathic granulomatous mastitis. Exclusion criteria: history of malignant breast neoplasia, history of HIV, systemic inflammatory pathology such as Wegener's granulomatosis, sarcoidosis, chronic granulomatous infections such as tuberculosis, brucellosis, histoplasmosis, syphilis and reactions to foreign bodies such as breast implant material. Demographic data, clinical presentation, mammographic and ultrasound findings and BIRADS categorization were analyzed. Univariate analysis was performed; frequencies and percentages were used for qualitative variables; measures of central tendency were used for quantitative variables. RESULTS. The median age was 36 years. 94,00% of patients had at least one child; 77,50% presented with a palpable mass; 55,10% were accompanied by inflammatory signs; 16,00% were associated with fistulas and 24,40% presented with discharge. Only 1 case presented bilateral involvement. CONCLUSION. In this study, idiopathic granulomatous mastitis affects women of reproductive age with no history of malignancy who present with a palpable breast mass that may be accompanied by inflammatory signs, collections and fistulas. The performance of an echo-guided core biopsy to confirm the diagnosis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Breast Diseases , Mammography , Ultrasonography, Mammary , Granulomatous Mastitis , Biopsy, Large-Core Needle , Mastitis , Pathology , Hyperprolactinemia , Colony-Stimulating Factors , Breast Implantation , Ecuador , Edema , Erythema , Image-Guided Biopsy , Fistula , Hyperemia , Nipples
8.
Rev. chil. obstet. ginecol. (En línea) ; 87(5): 333-349, oct. 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1423737

ABSTRACT

La patología mamaria durante el embarazo y la lactancia representa un desafío debido a que los cambios fisiológicos del tejido mamario durante este periodo pueden afectar la interpretación de los hallazgos clínicos e imagenológicos. El objetivo de esta revisión es conocer el diagnóstico diferencial de las enfermedades mamarias durante el embarazo y la lactancia. La mayoría de las patologías mamarias durante el embarazo y la lactancia son benignas y pueden ser clasificadas en tres categorías: 1) aquellas relacionadas con cambios fisiológicos, 2) enfermedades inflamatorias y 3) tumores benignos. Solo el 3% de los cánceres mamarios se desarrollan durante el embarazo. Los factores de mal pronóstico, como receptores hormonales negativos o HER2/neu positivo, en las mujeres embarazadas tienen una prevalencia similar a la observada en no embarazadas de la misma edad. El diagnóstico precoz es de crucial importancia pronóstica, por lo que es necesario mantener los esquemas de tamizaje recomendados. Es importante estar familiarizado con los cambios fisiológicos durante el embarazo y la lactancia, y conocer las patologías más prevalentes que afectan a las mujeres durante este periodo.


Breast pathology throughout pregnancy and lactation represents a challenge because the physiological changes of mammary tissue during this period may affect the interpretation of clinical and imaging findings. The objective of this presentation is to review the differential diagnosis of breast diseases during pregnancy and lactation. Most of breast pathology during pregnancy and lactation is benign and can be further classified into three categories: 1) those related to physiological changes, 2) inflammatory diseases, and 3) benign tumors. Only 3% of breast cancers will develop during pregnancy. Risk factors for worst prognosis, such as negative hormonal receptors or HER2/neu positive, in pregnant women have similar prevalence than in non-pregnant women of the same age. Early diagnose is of the outmost prognostic importance, therefore it`s important to maintain screening schedule as recommended. It is important to be familiarized with the physiological changes of the breast during pregnancy and lactation, and to know the most prevalent diseases affecting women during this period.


Subject(s)
Humans , Female , Pregnancy , Breast Diseases/diagnostic imaging , Breast Feeding , Mammography , Mass Screening , Ultrasonography, Mammary , Diagnosis, Differential
9.
Rev. argent. cir. plást ; 28(1): 25-28, 20220000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1392239

ABSTRACT

La hiperplasia pseudoangiomatosa estromal de la mama es una patología benigna de rara aparición en mujeres, que hoy en día sigue generando incertidumbre en cuanto a su manifestación y al tratamiento definitivo. Nuestro objetivo será detallar el manejo y los resultados obtenidos luego de tratar a una paciente con esta patología atendida en hospital público durante la pandemia, que presentó gigantomastia bilateral a expensas de crecimiento y simetrización de mama contralateral afectada por HEP durante su estado gravídico.


Pseudoangimatous stromal hyperplasia of the breast, is a pathology of rare appearance, in women, which today continues to generate uncertainty regarding its manifestation and definitive treatment. Our objective will be to detail the management and results obtained after treating a patient with this pathology in a public hospital during a pandemic. who presented bilateral gigantomastia at the expense of growth and symmetrization of the contralateral breast affected by HEP during her pregnancy.


Subject(s)
Humans , Female , Pregnancy , Adult , Breast Diseases/therapy , Pregnancy , Mastectomy, Segmental , Stillbirth , Fetal Death , Hyperplasia/pathology , Angiomatosis/pathology
10.
Rev. bras. ginecol. obstet ; 44(1): 67-73, Jan. 2022. tab, graf
Article in English | LILACS | ID: biblio-1365666

ABSTRACT

Abstract Objective To evaluate the underestimation rate in breast surgical biopsy after the diagnosis of radial scar/complex sclerosing lesion through percutaneous biopsy. Data Sources A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The PubMed, SciELO, Cochrane, and Embase databases were consulted, with searches conducted through November 2020, using specific keywords (radial scar OR complex sclerosing lesion, breast cancer, anatomopathological percutaneous biopsy AND/OR surgical biopsy). Data collection Study selection was conducted by two researchers experienced in preparing systematic reviews. The eight selected articles were fully read, and a comparative analysis was performed. Study selection A total of 584 studies was extracted, 8 of which were selected. One of them included women who had undergone a percutaneous biopsy with a histological diagnosis of radial scar/complex sclerosing lesion and subsequently underwent surgical excision; the results were used to assess the underestimation rate of atypical and malignant lesions. Data synthesis The overall underestimation rate in the 8 studies ranged from 1.3 to 40% and the invasive lesion underestimation rate varied from 0 to 10.5%. Conclusion The histopathological diagnosis of a radial scar/complex sclerosing lesion on the breast is not definitive, and it may underestimate atypical andmalignant lesions, which require a different treatment, making surgical excision an important step in diagnostic evaluation.


Resumo Objetivo Avaliar o grau de discordância entre biópsia percutânea e cirúrgica da mama em pacientes com diagnóstico de cicatriz radiada/lesão esclerosante complexa (CR/LEC) por meio de uma revisão sistemática. Fontes dos dados Foi realizada uma revisão sistemática segundo as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, na sigla em inglês). As bases de dados primárias consultadas foram PubMed, SciELO, Cochrane e Embase, combuscas conduzidas até novembro de 2020, utilizando palavras chaves específicas (cicatriz radiada OU lesão esclerosante complexa, câncer de mama, anatomopatológico de biópsia percutânea E/OU biópsia cirúrgica). Seleção dos estudos A busca dos artigos resultou em um total de 584 estudos, sendo 8 selecionados, os quais incluíam mulheres submetidas a biópsia com diagnóstico histológico de CR/LEC e posteriormente submetidas a exérese cirúrgica para avaliar como desfecho o grau de subestimação de lesões atípicas e malignas. Coleta de dados A seleção dos estudos foi conduzida por dois pesquisadores, com experiência na elaboração de revisão sistemática. Os oito artigos selecionados foram lidos na íntegra e submetidos a uma análise comparativa. Síntese dos dados Cicatrizes radiadas/lesões esclerosante complexas foram associadas com lesões atípicas e malignas após a exérese cirúrgica. O grau de subestimação geral foi calculado pela porcentagem de lesões atípicas e malignas no anatomopatológico após a exérese cirúrgica dentre o total de CR/LEC diagnosticadas, enquanto o grau de subestimação de lesões invasoras foi calculado considerando-se apenas os carcinomas invasivos. O grau de subestimação geral dos estudos selecionados variou de 1,3 a 40%, e o de lesões invasoras de 0 a 10,5%. Conclusão O diagnóstico histopatológico de CR/LEC na mama não é definitivo, podendo subestimar lesões atípicas e malignas, cujo tratamento é distinto, tornando a exérese cirúrgica etapa fundamental na investigação diagnóstica.


Subject(s)
Humans , Female , Breast Diseases/diagnosis , Breast Neoplasms/diagnostic imaging , Image-Guided Biopsy
11.
South African Family Practice ; 64(1): 1-5, 21 September 2022. Figures, Tables
Article in English | AIM | ID: biblio-1396526

ABSTRACT

A palpable breast lump is a common presentation of breast disease to a general practitioner. Fortunately, investigation of most of these lumps will lead to a benign diagnosis. It is essential to have a clear and systematic approach when investigating a palpable breast lump to avoid over investigation with the resultant increase in healthcare cost and anxiety. This article will discuss an approach to evaluating and diagnosing a palpable breast lump in the primary care setting


Subject(s)
Primary Health Care , Breast Diseases , Diagnostic Test Approval , Women
12.
Journal of Central South University(Medical Sciences) ; (12): 1769-1774, 2022.
Article in English | WPRIM | ID: wpr-971363

ABSTRACT

Ulnar-Mammary syndrome (UMS) is a rare monogenic disorder caused by mutations of the TBX3 gene. This paper reported a family of UMS. The proband, a 15-year old man, was presented with mammary gland dysplasia, ulnar limb defect, short stature, and delayed growth. Whole exome sequencing revealed a 1294_1301dup mutation in exon 6 of the TBX3 gene. Sanger sequencing was used to verify other members of the family, which suggested his mother also carried the same mutation, but merely resulting in the dysplasia of her left little finger. Notably, unilateral finger involvement without any systemic organ involvement was unusual in UMS patients. The proband then was treated with recombinant human growth hormone (rhGH) and human chorionic gonadotropin (hCG). After a year and a half, his height and secondary sexual characteristics were significantly improved. The clinical manifestations of the disease are highly heterogeneous, which is easy to be misdiagnosed and missed. When the diagnosis is unclear, genetic testing is helpful for auxiliary diagnosis.


Subject(s)
Humans , Male , Female , Adolescent , T-Box Domain Proteins/genetics , East Asian People , Breast Diseases/genetics , Mutation
13.
Online braz. j. nurs. (Online) ; 20: e20216508, 05 maio 2021. ilus
Article in English, Spanish, Portuguese | LILACS, BDENF | ID: biblio-1284571

ABSTRACT

OBJETIVO: Identificar na literatura científica a aplicação da laserterapia de baixa intensidade no tratamento de traumas mamilares em puérperas. MÉTODO: Trata-se de uma revisão integrativa da literatura. O levantamento das publicações ocorreu no período de setembro a novembro de 2020, utilizando os descritores "low-level light therapy" e "laser therapy", além da palavra-chave: "nipple trauma", nas bases de dados da PubMed, EMBASE, CINAHL, Scopuse Web of Science.Após a leitura e análise dos artigos, 3 artigos foram selecionados para a amostra final. RESULTADOS: Os dados analisados compuseram dois eixos temáticos denominados: "Uso da laserterapia no alívio da dor mamilar" e "Uso da laserterapia na cicatrização de fissuras mamilares". CONCLUSÃO: A aplicação da laserterapia resultou na diminuição da dor e boa regeneração tecidual mamilar, contribuindo para manutenção do aleitamento materno.


OBJECTIVE: To identify in the scientific literature the application of low-level laser therapy in the treatment of nipple traumas in puerperal women. METHOD: This is an integrative literature review.The survey of publications took place from September to November2020, using the descriptors "low-level light therapy" and "laser therapy", in addition to the keyword"nipple trauma", in the PubMed, EMBASE, CINAHL, Scopus and Web of Science databases.After reading and analyzing the articles, 3 were selected for the finalsample. RESULTS: The analyzed data composed two thematic axes, namely: "The use of laser therapy for nipple pain relief" and "The use of laser therapy in the healing of nipple fissures". CONCLUSION: The application of laser therapy resulted in pain reduction and in good nipple tissue regeneration, contributing to the maintenance of breastfeeding.


OBJETIVO: Identificar en la literatura científica la aplicación de laserterapia de baja intensidad en el tratamiento del traumatismo del pezón en mujeres posparto. MÉTODO: Se trata de una revisión integradora de la literatura. El levantamiento de publicaciones se realizó de septiembre a noviembre de 2020, utilizando los descriptores "low-level light therapy" y "laser therapy", además de la palabra clave: "nipple trauma", en las bases de datos de PubMed, EMBASE, CINAHL, Scopus y Web of Science. Después de leer y analizar los artículos, se seleccionaron 3 artículos para la muestra final. RESULTADOS: Los datos analizados comprendieron dos ejes temáticos denominados: "Uso de laserterapia para aliviar el dolor del pezón" y "Uso de laserterapia para la cicatrización de las grietas del pezón". CONCLUSIÓN: La aplicación de laserterapia dio como resultado una disminución del dolor y una buena regeneración del tejido del pezón, contribuyendo al mantenimiento de la lactancia.


Subject(s)
Humans , Female , Breast Diseases/radiotherapy , Breast Feeding/adverse effects , Low-Level Light Therapy , Postpartum Period , Nipples/injuries , Wound Healing/radiation effects , Breast Diseases/etiology , Mastodynia/radiotherapy
14.
Rev. chil. obstet. ginecol. (En línea) ; 85(6): 685-690, dic. 2020. tab, ilus
Article in Spanish | LILACS | ID: biblio-1508028

ABSTRACT

INTRODUCCIÓN: La filariasis con afectación mamaria es una enfermedad endémica de áreas tropicales y subtropicales de África, Asia, el Pacífico y América, que afecta a unos 120 millones de personas. Aunque es una patología rara en España, dado el aumento de pacientes procedentes de dichos países, debemos conocerla para saber diagnosticarla y tratarla adecuadamente. OBJETIVO DE REPORTAR EL CASO: Dar a conocer la filariasis con afectación mamaria, sus manifestaciones clínicas y radiológicas principales, a través de un caso clínico de nuestras consultas de ginecología. DESCRIPCIÓN DEL CASO: Paciente de 43 años, procedente de Guinea Ecuatorial que acude a la consulta de Ginecología por mastalgia bilateral y aumento del volumen de las mamas de semanas de evolución. La exploración es anodina por lo que se solicita mamografía bilateral en la que describen calcificaciones compatibles con filariasis. A pesar de que el resto de pruebas fueron negativas, dada la alta sospecha clínica y radiológica se diagnosticó de filariasis mamaria. CONCLUSIONES: A pesar de la actual campaña mundial para eliminar la filariasis, el aumento de migración global incrementa la probabilidad de padecer casos importados de filariasis mamaria. Por tanto, el conocimiento de las diferentes parasitosis es imprescindible para realizar un buen diagnóstico diferencial con otras entidades clínicamente similares, e instaurar el tratamiento más adecuado.


INTRODUCTION: Breast filariasis is an endemic disease from tropical and subtropical areas of Africa, Asia, the Pacific and America affecting about 120 million people. Although it is a rare pathology in Spain, given the increase in patients from the referred countries, we must be aware of it in order to know how to diagnose and treat it properly. OBJECTIVE OF REPORTING THE CASE: To raise awareness of filariasis with breast involvement and its main clinical and radiological manifestations, through a clinical case of our gynecology consultations. CASE REPORT: 43-year-old patient from Equatorial Guinea who comes to the Gynecology consultation for bilateral mastalgia and breast enlargement of weeks of evolution. The examination is anodyne, so bilateral mammography is requested in wich calcifications compatible with filariasis are described. Despite the rest of the tests are negative, given the high clinical and radiological suspicion, the diagnosis of breast filariasis is made. CONCLUSIONS: Despite the current worldwide campaign to eliminate filariasis, the increase in global migration enhances the probability of suffering from imported cases of breast filariasis Therefore, the knowledge of the different parasitoses is essential to make a correct differential diagnosis with other clinically similar entities, and to establish the most appropriate treatment.


Subject(s)
Humans , Female , Adult , Breast Diseases/pathology , Breast Diseases/diagnostic imaging , Filariasis/pathology , Filariasis/diagnostic imaging , Calcinosis , Mammography
15.
17.
Rev. argent. mastología ; 39(141): 15-33, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1104364

ABSTRACT

Objetivos El objetivo principal del siguiente trabajo es relacionar los hallazgos imagenológicos con los resultados histopatológicos de lesiones mamarias que requirieron biopsia. El primer objetivo secundario es evaluar el grado de subestimación de aquellas lesiones de riesgo a las que se le realizó Biopsia Radioquirúrgica (brq). El segundo objetivo secundario es conocer la sensibilidad y especificidad del bi-rads como método de diagnóstico para nuestra muestra. Material y método Se incluyeron 403 pacientes que fueron biopsiadas en el Centro de Diagnóstico y Tratamiento de Enfermedades Mamarias (cedytem) de la Ciudad de Santa Fe, en el período de tiempo comprendido entre el 1/1/15 y el 31/12/17. Los nódulos fueron punzados bajo guía ecográfica y las microcalcificaciones, asimetrías y distorsiones arquitecturales bajo guía estereotáxica. La concordancia entre los hallazgos imagenológicos e histopatológicos fue analizada teniendo en cuenta la clasificación de Parikh y Tickman. Resultados Se constató una buena relación entre las categorías bi-rads y la probabilidad de malignidad de las lesiones acorde a lo establecido por el Colegio Americano de Radiólogos (acr). Se observó un 100% de concordancia entre las lesiones categorizadas como benignas (bi-rads 3) y un 97% entre las categorizadas como malignas (bi-rads 5). Las lesiones categorizadas en el grupo de moderada a alta sospecha de malignidad (bi-rads 4B y bi-rads 4C) que resultaron benignas fueron reevaluadas para decidir nuevo control en 6 meses, repetir la biopsia o indicar la realización de brq. Se diagnosticaron 17 lesiones de riesgo (4,2%), de las cuales 12 fueron reevaluadas con brq, evidenciando un porcentaje de subestimación del 42%. Conclusiones A partir de los datos obtenidos, se calculó una sensibilidad del bi-rads como método de diagnóstico del 95% y una especificidad del 74%


Objectives The primary aim of the following work is to relate the imaging findings to the histopathological results of breast lesions that required biopsy. The second aim is to evaluate the degree of underestimation of those risk lesions that underwent a radio-surgical biopsy. The last objective is to know the sensibility and specificity of bi-rads as a diagnosis method for our sample. Materials and method This work included four hundred and three patients who were biopsied at Center for the Diagnosis and Treatment of Breast Diseases (cedytem) in the city of Santa Fe, in the time period between 1/1/15 and 12/31/17. The nodules were punctured under ultrasound guidance while microcalcifications, asymmetries and architectural distortions under stereotactic guidance. Results A good relationship was observed between the bi-rads categories and the probability of malignancy of the lesions according to what is established by the American College of Radiologists (acr). The imaging-histopathological findings correlation was evaluated taking into account the classification of Parikh and Tickman. A 100% correlation was observed between lesions categorized as benign (bi-rads 3), and 97% among those categorized as malignant (bi-rads 5). The lesions categorized as moderate or high suspicion of malignancy (birads 4B and bi-rads 4C) which turned out to be benign were re-evaluated to decide on having a new control in 6 months, repeating the biopsy or indicating the radio-surgical biopsy. Seventeen risk lesions (4.2%) were diagnosed of which twelve were reassessed with radio-surgical biopsy, evidencing an underestimation percentage of 42%. Conclusions Based on the data obtained, it was calculated for our sample a 95% sensitivity of the bi-rads and a 74% of specificity as a diagnostic method.


Subject(s)
Biopsy , Breast , Breast Diseases , Histology
18.
Rev. argent. mastología ; 39(141): 47-115, mar. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1104372

ABSTRACT

La práctica de la imagenología mamaria ha experimentado gran variedad de avances tecnológicos desde los primeros tiempos hasta nuestros días. La técnica de la mamografía se estableció desde un comienzo como el gold standart para el estudio de la mama, pasando desde la mamografía de película de exposición directa a la mamografía digital y tomosíntesis actual. Junto con estos progresos tecnológicos, se han propuesto regulaciones basadas en la calidad de los estudios mamográficos y el desarrollo unificado de informes con la intención de estandarizar el lenguaje y el informe mamográfico, para facilitar el entendimiento entre los diferentes especialistas implicados en el manejo de la patología mamaria y como herramienta de mejora continua en la calidad. A partir del desarrollo de la ecografía y de la resonancia mamaria como complementos de la mamografía, surgen algoritmos adicionales para el diagnóstico y la selección de subgrupos de riesgo. Este acelerado avance en la detección por imágenes de la patología mamaria y de las técnicas intervencionistas las ha transformado en herramientas fundamentales no solo para el diagnóstico del cáncer de mama sino también por la utilización de esa información con vistas a guiar los futuros tratamientos. En esta presentación, se propone una descripción de la historia y evolución de las imágenes de mamografía desde su creación hasta la actualidad, entendiendo que el conocimiento del pasado ayuda a comprender mejor los debates y controversias actuales


The practice of breast imaging has undergone a variety of technological advances from the earliest times to the present day. The mammography technique was established from the beginning as the gold standard for the study of the breast, from the mammography of direct exposure film to digital mammography and current tomosynthesis. Together with these technological advances, regulations based on the quality of mammographic studies and the unified development of reports are proposed, with the intention of standardizing the language and mammographic report, to facilitate understanding between the different specialists involved in the management of breast pathology and as a tool for continuous improvement in quality. From the development of ultrasound and breast resonance, as complements of mammography, additional algorithms arise for the diagnosis and selection of risk subgroups. This accelerated progress in the detection of breast disease along with interventional techniques have been fundamental tools, not only for diagnosing breast cancer, but also for the use of this information to guide future treatments. A description of the history and evolution of mammography images from its creation to the present is proposed in this presentation, understanding that knowledge about the past helps to better understand current debates and controversies


Subject(s)
Breast Diseases , Mammography , Technological Development , Ultrasonography , History
19.
Autops. Case Rep ; 10(4): e2020213, 2020. tab, graf
Article in English | LILACS | ID: biblio-1131848

ABSTRACT

Gigantomastia is a rare disease defined by an extreme and rapid enlargement of the breast, generally bilateral. The majority of cases are reported in pregnant women. Ninety-eight cases of gestational gigantomastia have been identified in electronic databases, and those with fatal outcomes comprised only 2 cases (2%). Despite its benign nature, it can lead to severe complications and even death. Its etiology has not been fully elucidated, but it has been speculated that a hormonal component may play a role in the pathogenesis. Currently, treatment options are limited, and surgery is gaining importance, but it is often not feasible in low-resource settings. Herein, we describe a case of a 30-year-old HIV-positive female with no relevant past medical history, who died due to the complications of gestational gigantomastia at the Maputo Central Hospital, in Mozambique.


Subject(s)
Humans , Female , Pregnancy , Adult , Breast/abnormalities , Breast Diseases/pathology , Pregnancy Complications , Autopsy , HIV , Fatal Outcome , Rare Diseases
20.
Journal of Southern Medical University ; (12): 562-566, 2020.
Article in Chinese | WPRIM | ID: wpr-828096

ABSTRACT

OBJECTIVE@#To evaluate the diagnostic efficacy of Kaiser score for breast lesions presenting as non-mass enhancement.@*METHODS@#We collected data from patients with breast lesions presenting as non-mass enhancement on preoperative DCE-MRI between January, 2014 and June, 2019. All the cases were confirmed by surgical pathology or puncture biopsy. With pathology results as the gold standard, we evaluated the diagnostic efficacy of Kaiser score and MRI BI-RADS classification and the consistency between the diagnostic results by the two methods and the pathological results.@*RESULTS@#A total of 90 lesions were detected in 88 patients, including 28 benign lesions (31.1%) and 62 malignant lesions (68.9%). For diagnosis of the lesions, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Kaiser Score were 100%, 75%, 89.9%, 100% and 92%, as compared with 93.5%, 46.4%, 79.5%, 76.5% and 78.9% of MRI BI-RADS, respectively. The diagnostic specificity of Kaiser score was significantly higher than that of BI-RADS classification (=0.021).@*CONCLUSIONS@#The Kaiser score system provides a diagnostic strategy for BI-RADS classification of breast lesions with non-mass enhancement and has a better diagnostic efficacy than BI-RADS classification alone. The use of Kaiser score can significantly improve the diagnostic specificity of such breast lesions for inexperienced radiologists.


Subject(s)
Humans , Breast , Breast Diseases , Diagnostic Imaging , Magnetic Resonance Imaging
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