[History of mastectomy before and after halsted]

The operation described by Halsted, in 1894 and called radical mastectomy, represents a milestone in the treatment of breast cancer. It consisted of removal of the breast, muscles and axillary lymph nodes. The pre-Halsted era saw attitudes ranging from the willful abstention to brutal treatments by cauterization or amputation. The introduction of anesthesia and asepsis enabled more advanced surgical attempts. The stratification of patients into operable and non-operable categories has improved surgical outcome. After attempts to extend Halsted procedure [by extended or super-radical mastectomies] proved to be of little benefit, a minimally-invasive trend emerged gradually. It started with modified radical mastectomy that spares the muscles and was then followed by breast conservative surgery that leaves breast tissue behind. Then sentinel lymph node mapping was introduced with the hope of reducing the extent of axillary dissection. Finally, skin sparing mastectomy appeared in order to conserve skin and facilitate breast reconstruction

multiple ultrasound patterns of ectopic pregnancy

Ectopic pregnancy [EP] has a variable and misleading clinical presentation contributing to the confusion with medical or other gynecological disorders. The rapid recourse to diagnostic methods, human chorionic gonadotropin [beta-hCG] titers and transvaginal ultrasonography, represents the best approach not only in the early diagnosis but also in the management and monitoring of patients with diagnosed EP. The purpose of this article is to provide a pictorial essay about EP and its multiple ultrasound [US] patterns. We present a large spectrum of EP aspects diagnosed on US and confirmed by pathology. We also review miscellaneous gynecologic diseases that may mimic EP on US. Although endovaginal US combined with quantitative [beta-hCG] analysis is an excellent tool for identifying EP, it may be normal sometimes in early pregnancies. Knowledge of all these patterns is helpful in establishing an early correct diagnosis, therefore leading to elective and conservative management in stable patients and preventing tubal rupture or substantial hemorrhage