جستجوی مقالات مرتبط با کلیدواژه « axilla » در نشریات گروه « پزشکی »

Idiopathic granulomatous mastitis (IGM) is a rare benign disease involving breast parenchyma mostly in the periareolar region. Childbearing women with a recent history of pregnancy and lactation are more at risk of IGM. The common locations of IGM are retro areolar or periareolar of the breast, but involvement of the axillary region in nonpregnant woman has never been reported elsewhere.

A 36-year-old female with a history of two times of pregnancy and lactation 8 months prior to presentation, referred with pain and swelling in the right axillary area. The past medical history and habitual history were negative and she did not use oral contraceptives or other medications. Local physical examination showed normal breasts with bilateral accessory breasts. A tender mass with the size of 4x6cm was palpable in the right axillary region accompanied by erythema and a few secretory fistulas without lymphadenopathy. Cell blood count, fasting blood glucose, HbA1C, and serum prolactin were normal. Ultra-sonography (US) demonstrated a soft tissue swelling, edema, and a decreased echogenicity area in the right axillary region compatible with IGM, which was further confirmed by biopsy. The patient was prescribed for on prednisolone 50mg per day and the condition did not improved for two months. To exclude other possible etiologies due to the atypical location, the patient underwent a second US and core-needle biopsy which confirmed the diagnosis of the axillary IGM. Prednisolone was tapered off and a non-steroidal anti-inflammatory drug (NSAID) started. All the symptoms improved in a month and fully resolved in 3 months.

IGM is not fully known yet, the presentation and the location can be variable. Considering IGM as a probable diagnosis in inflammatory presentation in the axillary region in patients with accessory breasts is suggested.

Cystic hygroma (CH) is a congenital malformation of the lymphatic system commonly treated with surgical excision. The typical locations of this lesion are the cervico-facial and cervicothoracic region and other rare locations include axilla, mediastinum, and limbs. CH usually presents at birth as a painless mass, which concerns parents. It might also be detected as complications resulting from it, such as respiratory distress fever, a sudden increase in the size, feeding difficulty, and infection. To the best of our knowledge, there are a few cases reported in cervico-axillo- thoracic variants and we reported giant cervico-axillo-thoracic cystic hygroma, which is thoroughly treated with surgical excision. A 45-days female, full-term delivery, infant presented with big right-side trunk mass, diagnosed through computed tomography scan as a CH involving the right lateral and posterior chest wall with extension to the axilla and right side of the neck, which was managed with surgical excision. After a 6-month of follow-up, no recurrent lesion masses were detected. CH is a congenital malformation of the lymphatic system that can be treated in the pediatric population. The treatment option depends on size, age, and location of the lesion. In our case, complete surgical excision was the selective treatment for this lesion.

one of the foremost usual methods for evaluating breast cancer is the removal of axillary lymph nodes (ALN) which include complications such as edema, limited hand movements, and lymph accumulation. Although studies have shown that the sentinel gland condition represents the axillary nodules context in the mammary gland, the efficacy, and safety of the guard node biopsy need to be evaluated. Subsequently, predicting axillary lymph node status before sentinel lymph node biopsy needs regular clinical data collection and would be supportive for oncologists and could keep the clinicians away from this strategy. Predictive modeling for lymph node statues may be one way to diminish the axillary lymph node dissection (ALND) and consequences.

The database used in this study was provided by Clinical Research Department, Breast Cancer Research Center, Motamed Cancer Institute (ACECR), Tehran, Iran. It contains clinical and demographic risk factors records of 5142 breast cancer patients from which a total of 38 features were selected. We performed modeling; based on six data mining algorithms (Decision Tree, Nave Bayesian, Random Forest, Support Vector Machine, Fast Large Margin, and Gradient Boosted Tree (GBT)). For evaluating the model, we used 10-fold cross-validation in Rapid Miner v9.7.001.

The results showed that the GBT model has a higher ability to predict lymph node metastasis than other models with an receiver operating characteristic (ROC) of 97%, a sensitivity of 96.59%, an accuracy of 90%, and specificity of 81%

Obviously, we have to diagnose cancer with a needle biopsy before surgery. Used data mining predictions and use of them to create a clinical decision support system for predicting cancer and lymph node statuses can help physicians and pathologists make the best decision for a patient's ALN surgery.

An axillary breast is a common condition, which can cause various diseases arising from the breast tissue. Among these diseases, phyllodes tumors are very rare fibroepithelial tumors, which resemble fibroadenomas. Surgical removal is the treatment of choice for phyllodes tumors to prevent recurrence. Inpatient treatment and general anesthesia are required for surgical removal, and fibrosis, skin scarring, and neurological symptoms may occur after surgery. Ultrasound-guided vacuum-assisted excision, because of its advantages, is an alternative to surgical excision for clinically benign breast masses. Therefore, in cases of clinically benign or concordant benign lesions, following a core needle biopsy, ultrasound-guided vacuum-assisted excision can be considered with sufficient preoperative measures and close follow-up of the ectopic axillary breast.

Pre-operative localization options in the axilla are limited. This study aimed to explore the utility of pre-operative localization of axillary lymph nodes using tattoo ink with multidisciplinary correlations.

In this prospective, Institutional Review Board (IRB)-approved study, 19 lymph nodes in 17 patients underwent pre-operative localization with ultrasoundguided injection of Spot tattoo ink. The success rate of intraoperative identification of the tattooed node as well as the frequency in which the tattooed node was also a sentinel node were recorded. Radiologic, surgical and pathologic images were collected.

Tattoo ink localization was successful in 16/17 (94.1%) of patients. Tattoo ink did not hinder pathologic evaluation in any cases but was taken up by additional adjacent nodes in 1/17 successful localizations (5.9%). Successful sentinel lymph node biopsy (SLNB) occurred in 13 patients in whom 14 lymph nodes underwent pre-operative tattoo ink localization. Nine of the 14 (64.2%) tattooed lymph nodes were also a sentinel node.

In this study, pre-operative localization of axillary lymph nodes with tattoo ink was highly successful In patients undergoing SLNB, a significant number of the tattooed nodes were not sentinel nodes (35.8%), suggesting the importance of targeted lymph node excision in addition to SLNB.

Axillary lymph node (LN) status plays an important role in the local and systemic treatment of patients with breast cancer. Preoperative axillary ultrasound (AUS) is routinely used for the evaluation of axillary lymph nodes as a non-invasive method.

The purpose of this study was to evaluate the sensitivity and specificity of axillary ultrasound in comparison with pathology in a referral breast center.

During a cross-sectional study all patients with breast cancer presenting to the imaging department between September 2015 and August 2016 were evaluated for axillary lymph node status by ultrasound. After comparing these results with the pathology of LNs, the sensitivity, specificity, and accuracy of the ultrasound in the diagnosis of axillary lymph node involvement were measured.

Overall 140 patients were enrolled in the study. The mean age of patients was 48.87 (± 10.46) years with an age range between 25 - 81 years. The sensitivity, specificity, and accuracy of the ultrasound were reported as 56%, 88%, and 76%, respectively. The highest sensitivity rate was related to AUS + Physical examination (PE) with 70%. The best specificity was for AUS, about 88%, and the accuracy of AUS+PE was the highest about 80%.

The sensitivity of the AUS in the diagnosis of axillary involvement in the Motamed Cancer Institute was moderate and the specificity was good. The combination of physical examination and ultrasound could improve the sensitivity in comparison to each one alone. If both are suspicious, axillary dissection could be considered when fine needle aspiration (FNA) or core needle biopsy (CNB) of the lymph node is not available.

Cancer of unknown primary involving axillary lymph nodes (CUPAx) is a very rare type of cancer. There are still many challenges about the management and outcome of the disease. This retrospective study is an attempt to assess the overall survival and the outcome of CUPAx in Iranian women.

Based on inclusion and exclusion criteria, 20 patients primarily diagnosed with CUPAx referred to our breast multidisciplinary team (MDT) sessions between July 2010 and December 2016 were evaluated. The patients were categorized into three groups based on the types of treatment: mastectomy and radiation therapy, radiation therapy, and observation group.

The mean age of the subjects was 52 ± 7.91 years (range: 42-74). The results manifested significant differences between the outcomes of three types of treatments. The patients who received both mastectomy and radiotherapy had a higher survival rate and no sign of the disease compared with other groups (P= 0.03). The median survival time in the mastectomy group was 78 months and 23 months for the group with no mastectomy (95% CI: 7.64-38.36) (P <0.001).

The result suggested that mastectomy was effective in lowering the risk of disease progression in Iranian women diagnosed with CUPAx and highly suspicious breast origin. More studies on larger sample groups are needed.