ABSTRACT
A glomus tumour is a benign mesenchymal tumour. It is extremely rare in the breast. We report a case of glomus tumour of the nipple in a 54-year-old man. To the best of the authors' knowledge, this is the first case report of a glomus tumour of the nipple. We describe the different presenting symptoms, method of diagnosis and treatment.
Subject(s)
Breast Neoplasms, Male , Glomus Tumor , Breast Neoplasms, Male/diagnosis , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/surgery , Glomus Tumor/diagnosis , Glomus Tumor/pathology , Glomus Tumor/surgery , Humans , Male , Middle Aged , Nipples/pathologyABSTRACT
OBJECTIVES: Inflammatory Breast cancer (IBC) is a rare but aggressive form of breast cancer. Its incidence and behaviour in the UK is poorly characterised. We collected retrospective data from hospitals in the UK and Ireland to describe the presentation, pathology, treatment and clinical course of IBC in the UK. MATERIALS AND METHODS: Patients with IBC diagnosed between 1997-2014 at fourteen UK and Irish hospitals were identified from local breast unit databases. Patient characteristics, tumour pathology and stage, and details of surgical, systemic and radiotherapy treatment and follow-up data were collected from electronic patient records and medical notes. RESULT: This retrospective review identified 445 patients with IBC accounting for 0.4-1.8% of invasive breast cancer cases. Median follow-up was 4.2 years. 53.2% of tumours were grade 3, 56.2% were oestrogen receptor positive, 31.3% were HER2 positive and 25.1% were triple negative. 20.7% of patients had distant metastases at presentation. Despite trimodality treatment in 86.4%, 40.1% of stage III patients developed distant metastases. Five-year overall survival (OS) was 61.0% for stage III and 21.4% for stage IV patients. CONCLUSIONS: This is the largest series of UK IBC patients reported to date. It indicates a lower incidence than in American series, but confirms that IBC has a high risk of recurrence with poor survival despite contemporary multi-modality therapy. A national strategy is required to facilitate translational research into this aggressive disease.
Subject(s)
Inflammatory Breast Neoplasms/epidemiology , Inflammatory Breast Neoplasms/therapy , Adult , Female , Humans , Ireland , Middle Aged , Multivariate Analysis , Neoplasm Staging , Receptor, ErbB-2/metabolism , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Retrospective Studies , Treatment Outcome , United KingdomABSTRACT
Chyle leak is a very rare complication following an axillary lymph node dissection. We report a case of chyle leak following sentinel lymph node biopsy in a patient with breast cancer with superior vena caval thrombosis. To our knowledge, this is the first case report of chyle leakage following axillary sentinel lymph node biopsy. We describe the aetiology, prevention and treatment strategy that can be adopted in these patients.
Subject(s)
Breast Neoplasms/surgery , Carcinoma, Intraductal, Noninfiltrating/surgery , Chyle , Postoperative Complications/diagnosis , Sentinel Lymph Node Biopsy , Superior Vena Cava Syndrome/complications , Venous Thrombosis/complications , Adult , Axilla , Breast Neoplasms/complications , Carcinoma, Intraductal, Noninfiltrating/complications , Female , Humans , Postoperative Complications/etiology , Postoperative Complications/therapySubject(s)
Breast/surgery , Clothing , Drainage/instrumentation , Postoperative Care/methods , Drainage/methods , Female , HumansABSTRACT
Implant based breast reconstruction after risk reducing mastectomy (RRM) is challenging as implants are inadequately covered in their lower pole. Also complication rates with one stage procedures are significant. We describe a novel method of pre-expansion by inserting subpectoral anatomical expandable implants to prepare the breast mound before RRM is carried out. Lipomodelling is later used to enhance the overall result of the reconstruction. Six patients who were BRCA 1 mutation carriers requested bilateral RRM. Median age was 31. All were non-smokers. Anatomical expandable implants were inserted via an inframammary incision and were expanded in the next two months. RRM was carried out 6-13 months later and was followed by lipomodelling seven months afterwards. Four patients had a nipple sparing mastectomy. In three cases access was via the previous inframammary scar. In all cases complete implant cover had been achieved. There were no early postoperative complications but one patient has developed grade III capsular contracture on the side of previous wide local tumour excision and radiotherapy. Five patients have so far undergone post-mastectomy lipomodelling to improve breast contour. In conclusion, we believe that our technique provides better aesthetic results with reduced complication rates for these patients.
Subject(s)
Adipose Tissue/surgery , Breast Implants , Mammaplasty/methods , Mastectomy/methods , Adult , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Female , Follow-Up Studies , Humans , Middle Aged , Retrospective Studies , Risk Factors , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: The C-V flap including its modifications is very popular flap used for nipple reconstruction. METHODS: This report describes a refinement of the C-V flap used in nipple reconstruction for patients who previously have undergone skin-sparing mastectomy and immediate breast reconstruction. Closure of the V flap donor sites is facilitated by means of designing two opposing advancement "areolar" skin flaps. RESULTS: Our modification ensures that no "dog ears" remain after the donor sites of the two V flaps are closed and that all scarring remains within the skin paddle of the neo-areola without any extensions on the mastectomy skin flaps. CONCLUSION: Our refinement of the closure for the donor site of the C-V flap used in nipple reconstruction produces an aesthetically pleasing result without unnecessary donor-site scar extensions on the mastectomy skin flaps.
Subject(s)
Mammaplasty/methods , Nipples/surgery , Surgical Flaps , Breast/surgery , Breast Neoplasms/surgery , Female , Humans , MastectomyABSTRACT
Injury to the milk-duct following a road traffic accident has not been reported in the literature. This case report describes a 25-year-old postpartum lady with massive swelling of the breast due to milk-duct injury and collection of milk within the breast. We describe the possible mechanism of milk-duct injury, its presentation and management, and also review the literature on seat-belt injury to the breast.
Subject(s)
Lactation Disorders/etiology , Mammary Glands, Human/injuries , Seat Belts/adverse effects , Accidents, Traffic , Adult , Automobile Driving , Breast Feeding/adverse effects , Cesarean Section , Female , Humans , Infant, Newborn , PregnancyABSTRACT
Assessment of patients with nipple discharge traditionally involves using a custom made device or by massaging or squeezing the nipple-areola complex to elicit the discharge. This can be painful and embarrassing for the patient. We describe a nipple discharge aspirator that is effective, cheap, easily available, acceptable to the patient and avoids squeeze technique.
Subject(s)
Breast Diseases/diagnosis , Nipples , Suction/instrumentation , Equipment Design , Female , HumansABSTRACT
A case of gastroduodenal intussusception caused by a submucosal gastric lipoma in a 48-year-old man is presented. He had intermittent symptoms of regurgitation and heartburn for a period of three years. Barium meal and CT scan showed a mass in the first part of duodenum. At laparotomy there was intussusception of gastric antrum into the duodenum with a submucosal lipoma in the antrum which formed the apex of the intussusception.
