ABSTRACT
BACKGROUND: Many patients with Medullary Thyroid Cancer (MTC) will have persistent or recurrent disease after surgery requiring lifelong surveillance with imaging and tumor markers. The objective of this study is to evaluate the efficacy of 68Ga-DOTATATE-PET (or 68Ga labelled equivalent radiopharmaceutical) versus 18F-FDG-PET for detecting persistent and/or metastatic recurrent MTC. METHODS: Relevant studies were identified by conducting searches in Embase and PubMed and five studies were included in the final review. RESULTS: Five studies investigated per-patient sensitivity of 18F-FDG-PET and 68Ga-DOTATATE-PET in MTC patients. Four studies investigated the correlation between calcitonin and number of lesions detected by 18F-FDG-PET and 68Ga-DOTATATE-PET, and three investigated the correlation between CEA and number of lesions detected by 18F-FDG-PET and 68Ga-DOTATATE-PET. There was no significant difference in number of lesions detected by 18F-FDG -PET compared with 68Ga-DOTATATE-PET. CONCLUSIONS: When compared directly to 18F-FDG-PET, there is a general trend towards favoring 68Ga-DOTATATE-PET in per-patient sensitivities, and incidence of lesion detection.
Subject(s)
Gallium Radioisotopes , Thyroid Neoplasms , Carcinoma, Neuroendocrine , Fluorodeoxyglucose F18 , Humans , Positron-Emission Tomography/methods , Radionuclide Imaging , Radiopharmaceuticals , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/surgeryABSTRACT
INTRODUCTION: Breast Conserving Surgery (BCS) is considered standard of care for women with early stage breast cancer. Between 20 and 50% of women treated with BCS will require re-operation for positive or close margins and it has been suggested that routine cavity shave margins may reduce the frequency of positive margins. METHODS: Retrospective chart review of a prospectively maintained surgical database of patients undergoing BCS for early stage breast cancer, at a single institution, between January 2012 and December 2015. Cohort was followed until June 2016 to capture re-operations. RESULTS: Among 2096 patients with stage 0-III breast cancers, 872 (42%) underwent primary mastectomies and 1224 (58%) underwent primary BCS. Margins were positive in 128 (11%) and close in 442 (36%). Re-operation rate for patients after BCS was 19%. CONCLUSION: A lower than predicted positive margin rate suggests that routine shave margins are not warranted at our institution.
Subject(s)
Breast Neoplasms/pathology , Breast Neoplasms/surgery , Margins of Excision , Mastectomy, Segmental , Adult , Aged , Aged, 80 and over , British Columbia , Female , Humans , Middle Aged , Neoplasm, Residual/pathology , Reoperation/statistics & numerical data , Retrospective StudiesSubject(s)
Empathy , Physician-Patient Relations , Surgeons/psychology , Awards and Prizes , Humans , Societies, Medical , United StatesABSTRACT
Intimate partner violence (IPV) is a crucial public health concern with substantial detrimental effects, including poorer physical and mental health as well as increased difficulties accessing formal services. Most research to date has focused on frequencies, barriers, and facilitators of service use among IPV survivors. However, what remains poorly understood is the perspectives of IPV survivors on their experiences of accessing multiple services after leaving the abusive situations. To answer this, six one-on-one semi-structured interviews were conducted with survivors using expanded definition of "services," which included social services, shelters, health care, police, legal assistance, and so forth. Data were analyzed using Constant Comparison. Four resulting themes were (a) Positive Aspects, (b) Negative Aspects, (c) Impact of Experiences With Services, and (d) Contextual Factors. Within each of these categories, several sub-categories emerged and are discussed within the context of the literature and recommendations are made for improving services for IPV survivors.
