ABSTRACT
Objetivo valorar los resultados de la biopsia del ganglio centinela (BGC) en pacientes con cáncer de mama multifocal (CMMF) en comparación con el unifocal (CMUF). Pacientes y métodos se han realizado e incluido en una base de datos de manera prospectiva 1.535 BGC a pacientes de 9 centros hospitalarios. De ellos 174 presentaban CMMF. Para la BGC se utilizaron coloides de Tc-99m y la vía de administración fue mayoritariamente la profunda, repartiendo el trazador en los diferentes focos. Resultados el índice de detección global fue del 93,8%, sin encontrar diferencias entre ambos grupos (el 94,8% en CMMF frente al 93,4%). La media de GC detectados fue de 1,46, siendo mayor en el grupo CMMF (1,58 frente a 1,45; p=0,036). La localización fue extraaxilar en el 19,6%, más frecuente en el grupo CMMF (el 23,4 frente al 18,9%, no significativo) y más en el territorio de la cadena mamaria interna y en el nivel III axilar. La incidencia de metástasis en los GC biopsiados fue del 27,3%, mayor en el grupo CMMF (el 29,1 frente al 26,7%, no significativo), con una media de GC afectados mayor (0,42 frente a 0,32, no significativo). En la linfadenectomía axilar se identificó afectación de ganglios adicionales en una proporción igual en ambos grupos (29,7%). Conclusionesla BGC parece tener un rendimiento similar en tumores unifocales y multifocales. En tumores multifocales, parece haber un patrón de drenaje linfático específico, con mayor número de GC detectados y probablemente con mayor número de localizaciones de GC extraaxilares (AU)
Objective To evaluate the results for sentinel node biopsy (SNB) in patients with multifocal breast cancer (MBC) in comparison to in those with unifocal breast cancer (UBC). Patients and methods A total of 1535 prospective SNB (174 on patients with MBC) were performed at 9 hospitals. In most patients, Tc-99m album in colloids were injected intraparenchymally into each tumoral focus for SNB. Results The overall identification rate was 93.8%; no differences between groups were observed (94.8% in MBC vs 93.4% in UBC). The mean number of sentinel nodes detected was 1.46, being higher in the MBC group than in the UBC group (1.58 vs 1.45; p=0.036). Extra-axillary sentinel nodes were found in 19.6%; extra-axillary sentinel nodes were more common in the MBC group (23.4% vs 18.9%, ns) and in the internal mammary chain and in level III axillary lymph nodes. The incidence of sentinel node metastasis was 27.3% (29.1% MBC vs 26.7% UBC, ns), and the mean number of positive sentinel nodes was 0.42 in the MBC group vs 0.32 in the UBC group (p=ns). Axillary dissection identified the same rate of positive additional nodes (29.7%) in both groups. Conclusions The diagnostic yield of SNB seems similar in MBC and UBC. In MBC, there appears to be a specific pattern of lymphatic drainage, with a higher number of sentinel nodes detected and probably a higher number of extra-axillary sentinel nodes (AU)
Subject(s)
Humans , Female , Breast Neoplasms/pathology , Sentinel Lymph Node Biopsy/methods , Lymphatic Metastasis/pathology , Axilla/pathology , Carcinoma, Ductal, Breast/pathologyABSTRACT
OBJECTIVE: To evaluate the results for sentinel node biopsy (SNB) in patients with multifocal breast cancer (MBC) in comparison to in those with unifocal breast cancer (UBC). PATIENTS AND METHODS: A total of 1535 prospective SNB (174 on patients with MBC) were performed at 9 hospitals. In most patients, Tc-99m albumin colloids were injected intraparenchymally into each tumoral focus for SNB. RESULTS: The overall identification rate was 93.8%; no differences between groups were observed (94.8% in MBC vs 93.4% in UBC). The mean number of sentinel nodes detected was 1.46, being higher in the MBC group than in the UBC group (1.58 vs 1.45; p=0.036). Extra-axillary sentinel nodes were found in 19.6%; extra-axillary sentinel nodes were more common in the MBC group (23.4% vs 18.9%, ns) and in the internal mammary chain and in level III axillary lymph nodes. The incidence of sentinel node metastasis was 27.3% (29.1% MBC vs 26.7% UBC, ns), and the mean number of positive sentinel nodes was 0.42 in the MBC group vs 0.32 in the UBC group (p=ns). Axillary dissection identified the same rate of positive additional nodes (29.7%) in both groups. CONCLUSIONS: The diagnostic yield of SNB seems similar in MBC and UBC. In MBC, there appears to be a specific pattern of lymphatic drainage, with a higher number of sentinel nodes detected and probably a higher number of extra-axillary sentinel nodes.
Subject(s)
Breast Neoplasms/pathology , Carcinoma/pathology , Sentinel Lymph Node Biopsy , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Prospective Studies , Young AdultABSTRACT
Objetivo: Valorar la evolución en el diagnóstico y tratamientodel carcinoma oculto de mama que se presenta comometástasis ganglionar.Pacientes y método: Trece mujeres diagnosticadas y tratadaspor haber presentado metástasis ganglionar de un carcinomade mama, sin localizar el foco primario.Resultados: Las 10 pacientes a las que se pudo aplicar cirugíaconservadora y radioterapia, evolucionaron favorablemente.Las tres que sólo recibieron hormonoterapia presentaronmastitis carcinomatosa a los pocos años.Conclusiones: Aunque la mamografía sigue siendo la exploraciónprincipal, la RNM y el PET ayudan a localizar algunoscarcinomas ocultos. Se confirma que el tratamiento consistenteen una linfadenectomía y radioterapia de la mama, esel de elección en la mayoría de los casos, frente a la cirugía radicalclásica(AU)
Objective: To evaluate the evolution in the diagnosis andtreatment of the occult breast carcinomas presented asmetastatic lymph node.Patients and methods: Thirteen women diagnosed andtreated of lymph node metastasis of breast cancer without primaryfocus localization.Results: Ten patients were treated with conservativesurgery and radiotherapy of the breast, presenting afavourable evolution. The 3 women that were treated onlywith hormonotherapy, had carcinomatous mastitis after fewyears.Conclusions: Mammography is still the gold standard testto study breast cancer. RNM and PET can help to localize occultbreast cancer. Lymphadenectomy and radiotherapy of thebreast is a good treatment in most cases, opposite to the classicalradical mastectomy(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Neoplasms, Unknown Primary/diagnosis , Neoplasms, Unknown Primary/therapy , Neoplasm Metastasis/therapy , Mammography/methods , Ultrasonography, Mammary , Lymph Node Excision/methods , Neoplasms, Unknown Primary/radiotherapy , Neoplasms, Unknown Primary/surgery , Neoplasms, Unknown Primary , Lymph Node Excision/trendsABSTRACT
Presentamos el caso de una mujer de 89 años de edad con un hidradenoma de células claras de mama que simuló un carcinoma primario. Se trata de un tumor de anejos cutáneos originado en las glándulas sudoríparas ecrinas, con un escaso número de casos publicados. Por ello describimos los aspectos clínicos y los hallazgos citomorfológicos e histopatológicos. Estos datos, junto con la literatura revisada, nos llevan a considerar que el hidradenoma de células claras debe ser incluido en el diagnóstico diferencial de los tumores mamarios, especialmente cuando esta neoplasia está ulcerada. (AU)
