ABSTRACT
OBJECTIVE: Minimally invasive surgery is increasingly gaining importance in breast surgery parallel to other surgical branches. Sentinel lymph node biopsy (SLNB) is a method that has radically changed the approach to breast surgery in the last decade of the 20(th) century. In this study, we aimed to evaluate the adaptation process to these alterations in breast surgery at our clinic. MATERIAL AND METHODS: Patients who underwent surgery with a diagnosis of breast cancer in our clinic between April 2010 and November 2013 were retrospectively evaluated in terms of demographic characteristics, the number of operations and type of surgical methods applied according to years, SLNB performance rate, and results of frozen section and histopathological analysis. The first year of SLNB practice was accepted as part of the learning curve, and 24 patients who were operated during that period underwent routine axillary dissection. RESULTS: The median age of 198 patients who were included in the study was 55 years (25-89). It was detected that the number of cases who underwent surgery for breast cancer increased in years, that the SLNB application rate increased from 37% to 66% between 2010 and 2013 (p=0.01), and SLNB staining rates increased from 70% to 94% (p=0.03). When only results from the last four years were evaluated, the mean staining rate in patients with SLNB (n=105) was 88% (n=92), with positive histopathology in 32% of these cases (n=30). Despite a decreasing trend over the years, a metastatic axillary lymph node was detected in paraffin block evaluation in spite of negative frozen section examination of SLNB in five cases, and 5 patients (5%) out of 97 patients who underwent breast conserving surgery required re-excision. The histopathological diagnosis was invasive ductal carcinoma in 84% (n=167) of patients. CONCLUSION: It was observed that during the four-year period of adaptation, the application rate of breast conserving surgery and SLNB reached accepted standards, and that both the technical problems encountered in SLNB and the requirement for re-excision after breast conserving surgery significantly decreased with increasing case volume and experience.
ABSTRACT
BACKGROUND: The aim of this study is to evaluate the clinical and histopathological features and the treatment of carcinoid tumors of the appendix. METHODS: A retrospective review of medical records and pathology specimens of patients with carcinoid tumor of the appendix has been done. The data derived from this study has been evaluated by descriptive statistical methods (mean, SD, frequency). RESULTS: The histopathological examination of the appendices revealed carcinoid tumor in 11 out of 6777 (0.16%) patients operated for acute appendicitis. Six (54.54%) patients were male, 5 (45.45%) were female and the mean age was 20.2+/-6.7 years (13-35). The tumor was localized in the distal 1/3 region in 10 patients and in the proximal 1/3 region in 1 patient. The mean tumor diameter was 0.73+/-0.36 cm (0.3-1.5). Ten patients had classical type carcinoid tumor whereas goblet cell carcinoid tumor was only seen in one patient. None of the patients underwent an expanded resection. The mean follow up of the patients is 28.5+/-15.2 months (6-48), and no recurrences were seen. CONCLUSION: In tumors with a diameter of 1 to 2 cm, appendectomy is the treatment of choice. No recurrence was detected with tumors smaller than 2 cm with simple appendectomy.
