ABSTRACT
This section considers the treatment options for perimenopausal women with breast cancer. The perimenopause period begins in the so-called stage 2 of menopausal transition (early menopausal transition, where the length of the cycles changes by 7 days or more) and ends after 12 months of amenorrhea. It is characterized by an early increase in follicle-stimulating hormone and is associated with the presence of anovulatory cycles, irregular periods, and loss of menstrual cycles. The recommended treatment is tamoxifen (TAM) with or without ovarian ablation for 2 or 3 years followed by a re-evaluation. TAM should be maintained if the patient is premenopausal and aromatase inhibitors (AI) are recommended once the menopausal status is confirmed. Ovarian suppression is an acceptable adjuvant therapy in those patients with hormone-sensitive tumors. AI should only be used in postmenopausal women or in combination with chemical castration in premenopausal women. This supplement paper includes the key points of roundtable presentations and discussions of hormonal therapy in breast cancer.
Subject(s)
Antineoplastic Agents, Hormonal/administration & dosage , Aromatase Inhibitors/administration & dosage , Breast Neoplasms/drug therapy , Breast Neoplasms/mortality , Perimenopause/drug effects , Adult , Age Factors , Antineoplastic Agents, Hormonal/adverse effects , Aromatase Inhibitors/adverse effects , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Chemotherapy, Adjuvant , Disease-Free Survival , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Mastectomy/methods , Middle Aged , Neoplasm Invasiveness/pathology , Neoplasm Staging , Patient Selection , Perimenopause/physiology , Prognosis , Randomized Controlled Trials as Topic , Risk Assessment , Survival Analysis , Tamoxifen/administration & dosage , Tamoxifen/adverse effects , Treatment OutcomeABSTRACT
Brachial cysts are abnormalities in the development of the branchial apparatus, being the more common ones those of the second arch. Cysts localized in the pharyngeal wall (Bailey's type IV) are extremely rare; therefore its differential diagnosis should include all benign and malignant lesions that can be found in the pharyngeal wall. Treatment is the total excision of the cyst through per oral or external cervical approach in order to avoid recurrences.
Subject(s)
Branchioma/diagnostic imaging , Pharyngeal Neoplasms/diagnostic imaging , Adult , Branchioma/surgery , Humans , Male , Pharyngeal Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
Lingual abscesses have become extremely rare since the discovery of antibiotics, with only about 200 cases reported in the last 160 years. Diagnosis on the basis of clinical symptoms alone is quite difficult. Imaging studies are essential for the diagnosis of lingual abscesses and for their differentiation from related pathologies with similar clinical symptoms. We report a case of lingual abscess with otherwise unremarkable clinical findings that was diagnosed by CT scan. The etiology, pathophysiology, bacteriology, diagnosis, and treatment of these uncommon infections is discussed.
