ABSTRACT
INTRODUCTION: The cavity shaving (CS) technique was described in breast conserving surgery to reduce the rate of reoperation avoiding the need for intraoperative margin analysis. This study assesses differences in the rates of involvement of the surgical margin (requiring further surgery) and volume of surgical specimens, depending on the use or not of this technique. MATERIAL AND METHODS: A retrospective cohort study was conducted in patients with breast carcinoma who underwent breast conserving surgery between 2013 and 2019. They were divided into two groups depending on whether the cavity shaving technique was used or not. Primary outcomes of the study included presence of final margin involvement, requiring need for further surgery, and the volume of excised tissue comparing the study groups. RESULTS: A total of 202 cases were included: 92 in the control group and 110 in the cavity shaving group. Significant differences were found regarding involvement of the final margin (19.57% control group vs. 4.55% cavity shaving group; p = 0.010). The volume of additional surgical specimens were significantly greater in the traditional technique group than in the shaving technique (46.43 vs 13.32 cm3; p = 0.01) as was total specimen volume (143.40 vs 100.63 cm3; p = 0.022). CONCLUSIONS: CS can reduce the positive margin and re-excision rates without larger-volume resections and should therefore be considered a routine technique in BCS for early-stage breast cancer.
Subject(s)
Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/surgery , Margins of Excision , Mastectomy/methods , Reoperation/statistics & numerical data , Specimen Handling/methods , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/pathology , Case-Control Studies , Female , Follow-Up Studies , Humans , Middle Aged , Prognosis , Retrospective StudiesABSTRACT
Objetivo: La quimioterapia neoadyuvante (QTN) es una modalidad de tratamiento fundamental en el cáncer de mama (CM). El objetivo de este estudio es analizar las respuestas radiológica (RR) y patológica (RP) de pacientes con CM sometidas a QTN, estudiar su concordancia y las variables relacionadas con dichas respuestas. Pacientes y métodos: Se incluyen 63 pacientes tratadas con QTN en las que se evaluó la RR con RM pre y post-QTN, y la RP, mediante la clasificación de Miller y Payne, tanto para la enfermedad mamaria como para la axilar. Se realizó un análisis univariante y multivariante de las variables clinicopatológicas para la RR y RP, así como un análisis de concordancia entre respuestas. Resultados: Los porcentajes de respuesta fueron del 52,4% para RR, del 63,5% para RP local y del 57,2% para RP axilar. Resultaron factores predictivos independientes de la RR: un BRCA+ y el tipo de curva en la RM post-QTN. El único factor predictivo para la RP en la mama fue el realce tumoral en la RM post-QTN y para la RP axilar: realizar la BSGC y receptores hormonales negativos. Aunque se identifica correlación entre RR y RP, esta solo fue significativa en la enfermedad axilar. Conclusiones: Existen factores predictivos de RR, RP en mama y RP axilar que hacen útil el uso de la RM en la valoración de la QTN. La concordancia entre RR y RP fue mayor a nivel axilar
Aim: Neoadjuvant chemotherapy (NAC) is a fundamental treatment in breast cancer (BC). The objective of this study was to analyse the radiological response (RR) and pathological response (PR) of patients with BC by studying the agreement between RR and PR and response-related variables. Patients and methods: The study included 63 patients treated with NAC. We evaluated RR with pre- and post-CT MRI and PR by the Miller and Payne classification, both for breast and axillary disease. Univariate and multivariate analyses of the clinicopathological variables for RR and PR were carried out, as well as an analysis of the concordance between responses. Results: The response rates were 52.4% for RR, 63.5% for local PR and 57.2% for axillary PR. Independent predictive factors of RR were BRCA positivity and the type of curve post-NAC on MRI. The only independent predictor of PR in the breast was tumor enhancement post-NAC on MRI, while independent predictors of axillary PR were performing SSNB and negative hormone receptors. Although there was a correlation between RR and PR, it was only significant in axillary disease. Conclusions: This study found predictive factors of RR, PR in the breast and axillary PR and consequently RMI is useful in the assessment of NAC. The concordance between RR and PR was greater in the axilla
Subject(s)
Humans , Female , Neoadjuvant Therapy/methods , Breast Neoplasms/drug therapy , Magnetic Resonance Spectroscopy/methods , Chemotherapy, Adjuvant/methods , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Treatment Outcome , Retrospective StudiesABSTRACT
La pancreatitis del surco representa una forma segmentaria de pancreatitis crónica que afecta la región periduodenal, entre la pared duodenal y el páncreas. Esta entidad es poco frecuente y posee ciertas características clínico patológicas que permiten identificarla preoperatoriamente. Esta condición ha recibido varios nombres entre estos: distrofia quística del páncreas heterotópico, hamartoma pancreático del duodeno, quiste paraduodenal y mioadenomatosis del páncreas. Presentamos dos casos de pancreatitis del surco en piezas de duodenopancreatectomía en hombres de 39 y 50 años, ambos bebedores de alcohol. Los estudios de imagen mostraron en ambos lesiones quísticas intrapancreáticas. Histológicamente se observó engrosamiento de la mucosa duodenal, hiperplasia severa de las glándulas de Brunner, proliferación miofibroblástica con formaciones quísticas, entremezclada con tejido pancreático e inflamación crónica. Esta entidad entra en el diagnóstico diferencial de las lesiones pseudotumorales pancreáticas que pueden simular carcinoma(AU)
Groove pancreatitis is a form of chronic segmental pancreatitis affecting the periduodenal region between the duodenum and the head of the páncreas. This uncommon entity has distinct clinicopathological features which facilitate its preoperative diagnosis. It is also been known as cystic dystrophy in heterotopic páncreas, pancreatic hamartoma of the duodenum, paraduodenal cyst and adenomyomatosis of the páncreas. We present two cases of groove pancreatitis in adult males aged 39 and 50, both alcohol drinkers, who had undergone pancreatoduodenectomy. Imaging studies showed cystic intrapancreatic lesions. Histologically, a large duodenal wall with prominent myofibroblastic proliferation and cysts admixed with pancreatic tissue and cronic inflammation was seen. Groove pancreatitis may be confused with carcinoma(AU)
Subject(s)
Humans , Male , Adult , Middle Aged , Pancreatitis/pathology , Brunner Glands/pathology , Pancreatic Neoplasms/pathology , Pancreatectomy/methods , Pancreatectomy/trends , Pancreaticoduodenectomy/methods , Pancreaticoduodenectomy/trends , Pancreatic Ducts/pathology , Diagnosis, Differential , Granuloma, Plasma Cell/pathology , Duodenal Diseases/pathology , Duodenal Neoplasms/pathologySubject(s)
Colonic Polyps/pathology , Colonoscopy , Epithelial Cells/ultrastructure , Giant Cells/ultrastructure , Aged , Biopsy , Colonic Polyps/diagnosis , Cytomegalovirus Infections/diagnosis , Cytopathogenic Effect, Viral , Diagnosis, Differential , Female , Humans , Hyperplasia , Male , Middle AgedSubject(s)
Humans , Male , Female , Middle Aged , Aged , Endoscopy, Gastrointestinal , Colonic Polyps/pathology , Epithelial Cells/pathology , Biopsy/methodsABSTRACT
BACKGROUND: The aim of this paper is to determine the possible association between five different profiles of immunohistochemical expression related to clinical, histopathological and immunohistochemical known prognostic value variables for breast cancer. MATERIAL AND METHOD: A total of 194 breast carcinoma tumour samples were studied. In this study five groups or immunohistochemical profiles were defined, based on expression of hormone receptors (oestrogen or progesterone) and/or Her2/neu (luminal-type A, luminal-type B, mixed profile, Her2/neu profile and triple-negative-type profile) and we studied whether there are differences between them with regard to clinical, histopathological and immunohistochemical variables that have a known prognostic significance. RESULTS: In the series we found 134 (69%) cases corresponding to a luminal immunophenotype, of which 98 (50.5%) were from the luminal A group and 36 (18.6%) from luminal B. Twenty-nine cases (15.9%) were triple-negative, 18 (9.3%) mixed and 13 (6.7%) Her2/neu type. It is worth noting the relationship between the triple-negative and Her2/neu immunophenotypes and the more poorly differentiated histological forms (62% and 60%, respectively) and between the luminal A group and well-differentiated tumours (p = 0.008). Expression of ki67 was high in the triple-negative group (73.9%) and low in the luminal A group (26.3%; p = 0.001). The expression of p53 was also greater for the Her2/neu (55.5%) and triple-negative (60.8%) groups (p = 0.0005) than for the others. CONCLUSIONS: The subgroups without hormone receptor expression, with Her2/neu overexpression or without (triple-negative group), have characteristics associated with variables of a poorer prognosis. The lack of progesterone receptor expression also seems to be associated with these.
Subject(s)
Breast Neoplasms , Carcinoma, Ductal , Biomarkers, Tumor , Breast Neoplasms/classification , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Carcinoma, Ductal/classification , Carcinoma, Ductal/metabolism , Carcinoma, Ductal/pathology , Female , Humans , Immunohistochemistry , Middle Aged , PhenotypeABSTRACT
Introducción. El objetivo de este trabajo es determinarla posible asociación de cinco perfiles diferentes de expresión inmunohistoquímica con variables clínicas, histopatológicas e inmunohistoquímicas de conocido valor pronóstico en el cáncer de mama. Material y método. Se estudiaron 194 muestras de carcinoma ductal infiltrante de mama. Se definieron 5perfiles inmunohistoquímicos basados en la expresión de receptores hormonales (estrogénicos o de progesterona)y/o Her2neu (luminal A, luminal B, mixto,Her2neu y triple negativo) y se estudió si había diferencias entre ellos en relación con variables clínicas, histopatológicas e inmunohistoquímicas de conocido valor pronóstico. Resultados. En la serie se encontraron 134 (69%) casos correspondientes a un inmunofenotipo luminal, de los que 98 (50,5%) fueron del grupo luminal A y 36(18,6%) del luminal B; 29 (15,9%) casos fueron triples negativos, en 18 (9,3%) se daba un tipo mixto y en 13(6,7%), del tipo Her2neu. Destaca la relación entre los inmunofenotipos triple negativos y Her2neu con formas histológicas peor diferenciadas (el 62 y el 60%,respectivamente) y del grupo luminal A con tumores bien diferenciados (p = 0,008). La expresión de ki67fue mayor en el grupo triple negativo (73,9%) y baja en el luminal A (26,3%) (p = 0,001). La expresión de p53también fue mayor para los grupos Her2neu (55,5%) y triple negativo (60,8%) (p = 0,0005) respecto a los otros. Conclusiones. Los subgrupos sin expresión de receptores hormonales, con sobreexpresión de Her2neuo sin ella (triple negativo) presentan características asociadas con variables de peor pronóstico. La pérdida de expresión de receptores a progesterona también parece asociarse con ellas (AU)
Background. The aim of this paper is to determine the possible association between five different profiles of immunohistochemical expression related to clinical, histopathological and immunohistochemical known prognostic value variables for breast cancer. Material and method. A total of 194 breast carcinomatumour samples were studied. In this study five groups or immunohistochemical profiles were defined, based on expression of hormone receptors (oestrogenor progesterone) and/or Her2/neu (luminaltypeA, luminal-type B, mixed profile, Her2/neu profile and triple-negative-type profile) and we studied whether there are differences between them with regard to (..) (AU)
Subject(s)
Adult , Middle Aged , Aged , Aged, 80 and over , Humans , Breast Neoplasms/diagnosis , Receptors, Progesterone/metabolism , Receptors, Estrogen/metabolism , Breast Neoplasms/pathology , Breast Neoplasms/epidemiology , Biomarkers, Tumor , Immunohistochemistry , PrognosisABSTRACT
El carcinoma intraductal de glándula salival mayor es un tumor agresivo tanto clínica como citológicamente. En glándula salival menor, son muy raros y a pesar de tener una citología agresiva son tumores con buen comportamiento clínico. Presentamos un caso en paladar blando, fácilmente diagnosticable por la presencia de abundantes células mioepiteliales que rodean conductos con células epiteliales grandes, atípicas, con mitosis y necrosis. Un año después de la extirpación permanece asintomático
Intraductal carcinoma of major salivary gland is a very agressive neoplasm in clinical and cytological grounds. In minor salivary gland it´s very rare and have a good clinical evolution irrespective of the cytological agressivity. We report a case in soft palate, without diagnostics problems by the easy demonstration of myoepithelial cells around all epithelial units.The epithelial cells are large, atypical with mitosis and necrosis.A year later the patient is well
Subject(s)
Humans , Male , Aged , Salivary Glands, Minor/pathology , Salivary Gland Neoplasms/pathology , Carcinoma, Intraductal, Noninfiltrating/pathology , Myoepithelioma/pathology , S100 Proteins/analysisABSTRACT
El pólipo fibroepitelial estromal es una entidad benigna, cuya peculiaridad más importante es la variedad de hallazgos histopatológicos que puede presentar, y que todavía frecuentemente se diagnostica erróneamente como maligno, a pesar de que es una entidad bastante bien estudiada en la literatura. Hemos recogido nuestra casuística en los últimos 5 años y revisado la literatura (AU)
Subject(s)
Adult , Female , Middle Aged , Humans , Polyps/pathology , Genital Neoplasms, Female/pathology , Neoplasms, Fibroepithelial/pathologyABSTRACT
Los tumores del estroma gastrointestinal forman un grupo infrecuente de neoplasias. Representan únicamente el 1-2 por ciento del total de tumores del tracto digestivo y la localización anorrectal es una de las menos descritas en la bibliografía. Se presenta un caso de tumor del estroma gastrointestinal situado en la parte distal del recto y el canal anal en un varón de 44 años de edad. Se revisan los datos clínicos y de tratamiento más significativos de este tipo de neoplasias (AU)
Subject(s)
Adult , Male , Humans , Mesenchymoma/surgery , Anus Neoplasms/surgery , Rectal Neoplasms/surgery , Mesenchymoma/diagnosis , Mesenchymoma/pathology , Cell Cycle Proteins , Digestive System Surgical Procedures/methods , Anus Neoplasms/diagnosis , Anus Neoplasms/pathology , Rectal Neoplasms/diagnosis , Rectal Neoplasms/pathology , Proto-Oncogene Proteins c-kitABSTRACT
El tumor filodes es un tumor mamario infrecuente, de estirpe fibroepitelial, que tiene generalmente un comportamiento biológico benigno. En el presente trabajo presentamos un caso clínico de tumor filodes maligno multicéntrico y unilateral (AU)
Subject(s)
Adult , Female , Humans , Fibroadenoma/diagnosis , Biopsy, Needle/methods , Mastectomy, Modified Radical/methods , Lymph Node Excision/methods , Tomography, Emission-Computed/methods , Ifosfamide/therapeutic use , Ifosfamide/administration & dosage , Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Phyllodes Tumor/surgery , Phyllodes Tumor/diagnosis , Phyllodes Tumor/drug therapy , Neoplasm Metastasis , Breast Neoplasms , Breast Neoplasms/epidemiologyABSTRACT
Epithelioid-cell blue nevus is an unusual cytologic variant of blue nevus that has been recently described mostly in patients with Carney complex, although the lesion may also appear in patients with no evidence of Carney complex. This variant of blue nevus is composed of melanin laden large polygonal epithelioid melanocytes situated within the dermis. The neoplastic cells show no maturation with progressive descent and, in contrast with the usual stromal changes in blue nevi, epithelioid-cell blue nevus exhibits no dermal fibrosis. This report describes a congenital giant melanocytic nevus with pigmented epithelioid cells located on the back of a 2-year-old male. The lesion was present at birth and the patient had no evidence of Carney complex. Histopathologically, the lesion consisted of a large and entirely intradermal melanocytic nevus composed of heavily pigmented epithelioid melanocytes involving the full-thickness of dermis, but extending also to the subcutaneous fat and underlying soft tissues. Immunohistochemically, epithelioid neoplastic melanocytes expressed immunoreactivity for S-100 protein, HMB-45, Melan-A, NK1C3, and microphthalmia transcription factor (MiTF) antibodies. MIB-1 cellular proliferation marker was expressed in the nuclei of only a few scattered epithelioid melanocytes. This report demonstrates that epithelioid-cell blue nevus is a distinctive histopathologic variant of blue nevus that may also appear as a giant congenital melanocytic nevus.
