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排序方式: 共有132条查询结果,搜索用时 15 毫秒
101.
Dominik Taterra Brandon Michael Henry Michał P. Zarzecki Beatrice Sanna Przemysław A. Pękala Roberto Cirocchi Jerzy A. Walocha R. Shane Tubbs Krzysztof A. Tomaszewski 《The surgeon》2019,17(1):43-51
Purpose
The following research aimed to investigate the prevalence and anatomical features of the axillary arch (AA) – a muscular, tendinous or musculotendinous slip arising from the latissimus dorsi and that terminates in various structures around the shoulder girdle. The AA may complicate axillary lymph node biopsy or breast reconstruction surgery and may cause thoracic outlet syndrome.Methods
Major electronic databases were thoroughly searched for studies on the AA and its variations. Data regarding the prevalence, morphology, laterality, origin, insertion and innervation of the AA was extracted and included in this meta-analysis. The AQUA tool was used in order to assess potential risk of bias within the included studies.Results
The AA was reported in 29 studies (10,222 axillas), and its pooled prevalence estimate in this meta-analysis was found to be 5.3% of the axillas: unilaterally (61.6%) and bilaterally (38.4%). It was predominantly muscular (55.1% of the patients with the AA), originated from the latissimus dorsi muscle or tendon (87.3% of the patients with the AA), inserted into the pectoralis major muscle or fascia (35.2% of the patients with the AA), and was most commonly innervated by the thoracodorsal nerve (39.9% of the patients with the AA).Conclusion
The AA is a relatively common variant, hence it should not be neglected. Oncologists and surgeons should consider this variant while diagnosing an unknown palpable mass in the axilla, as the arch might mimic a neoplasm or enlarged lymph nodes. 相似文献103.
Ji Hyun Youk Eun Ju Son Jeong-Ah Kim Hye Mi Gweon 《Ultrasound in medicine & biology》2017,43(8):1581-1586
The aim of this study was to evaluate shear wave elastography (SWE) for pre-operative evaluation of axillary lymph node (LN) status in patients with suspected breast cancer. A total of 130 axillary LNs in 130 patients who underwent SWE before fine-needle aspiration, core biopsy or surgery were analyzed. On gray-scale images, long and short axes, shape (elliptical or round), border (sharp or unsharp) and cortical thickening (concentric, eccentric or no fatty hilum) of LNs were assessed. On SWE, mean, maximum, minimum, standard deviation and the lesion-to-fat ratio (Eratio) values of elasticity were collected. Gray-scale and SWE features were compared statistically between metastatic and benign LNs using the χ2-test and independent t-test. Diagnostic performance of each feature was evaluated using the area under the receiver operating characteristic curve (AUC). Logistic regression analysis was used to determine gray-scale or SWE features independently associated with metastatic LNs. Of the 130 LNs, 65 (50%) were metastatic and 65 (50%) were benign after surgery. Metastatic LNs were significantly larger (p = 0.018); had higher elasticity indexes at SWE (p < 0.0001); and had higher proportions of round shape (p = 0.033), unsharp border (p = 0.048) and eccentric cortical thickening or no fatty hilum (p = 0.005) compared with benign LNs. On multivariate analysis, Eratio was independently associated with metastatic LNs (odds ratio = 3.312, p = 0.008). Eratio had the highest AUC among gray-scale (0.582–0.719) and SWE (0.900–0.950) variables. SWE had good diagnostic performance in metastatic axillary LNs, and Eratio was independently associated with metastatic LNs. 相似文献
104.
105.
Chandler Scott Cortina Ashley A. Woodfin Laurel L. Tangalakis Xuanji Wang Jennifer D. Son Jennifer Poirier Ruta Rao Katherine Kopkash Andrea Madrigrano 《Breast care (Basel, Switzerland)》2021,16(3):276
IntroductionBreast cancer is the second most common cause of cancer death in females, and 30% of these patients are over the age of 70 years. Studies have shown deviation from the standard treatment paradigms in the elderly, especially in regard to radiation treatment.MethodsWe performed a retrospective chart review on 118 patients over the age of 70 years diagnosed with breast cancer and pathologically proven axillary disease over an 8-year period at an urban academic hospital to examine which patient factors influenced radiotherapy.ResultsIncreasing patient age was associated with a decrease in the probability of receiving radiotherapy, while HER2-negative patients were more likely to receive radiation. Neither race, number of coexisting medical conditions, or insurance status showed any influence on radiation treatment.ConclusionPatient age has a significant influence if elderly patients with axillary disease receive radiotherapy. Further investigation and validation are needed to understand why chronological age rather than biological age influences treatment modalities. 相似文献
106.
Seung Ook Hwang Sang-Woo Lee Hye Jung Kim Wan Wook Kim Ho Yong Park Jin Hyang Jung 《JOURNAL OF BREAST CANCER》2013,16(3):315-321
Purpose
A more noninvasive evaluation of axillary lymph node in breast cancer is one of the principal challenges of breast cancer treatment. To detect axillary lymph node metastasis (ALNM) in T1 breast cancer, we have compared the axillary ultrasonography (AUS), contrast-enhanced magnetic resonance imaging (cMRI), and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) to determine the most adequate test or a combination of tests.Methods
Retrospectively, 349 T1 breast cancer patients who were preoperatively examined using AUS, cMRI, and PET/CT between 2008 and 2011 and whom underwent pathological evaluations of axillary lymph nodes were reviewed and analyzed.Results
In total, 26.4% (92/349) of patients exhibited ALNM. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of AUS for determining ALNM were 44.6%, 88.7%, 58.6%, 81.7%, and 77.1%, respectively. cMRI was similar to AUS. The sensitivity, specificity, PPV, NPV, and accuracy of PET/CT were 44.5%, 94.2%, 73.2%, 82.6%, and 81.1%, respectively. The combination including cMRI and PET/CT was the most accurate with sensitivity, specificity, PPV, NPV, and accuracy values of 39.1%, 98.8%, 92.3%, 81.9%, and 83.1%, respectively. The mean number (3.5±4.2) of ALNMs in the patients who were positive based on cMRI and PET/CT and also pathologically proven to exhibit ALNM was significantly larger than the number (2.16±2.26) in other patients who exhibited ALNM (p=0.035).Conclusion
There are no definitive modalities for detecting ALNM in T1 breast cancers to replace sentinel lymph node biopsy (SLNB). If ALNM is suspected based on cMRI and PET/CT, the axillary dissection without SLNB might be a better option because it is related to high possibilities of ALNM and large axillary metastatic volumes. 相似文献107.
患者男,83岁。左侧腋窝红斑伴瘙痒6年。多次按湿疹治疗,无效;3年前始皮损伴轻度疼痛,瘙痒明显,反复破溃不能愈合。近日来皮损增大明显,予手术切除。切除物组织病理示:表皮轻度角化过度,表皮全层可见单个或成巢的Paget细胞,真皮浅层较多淋巴细胞浸润;AB染色(+),PAS染色(-);免疫组化示:CK7,CK8/18,CEA和Ki67均(+);S100和HMB45均(-)。诊断:乳房外Paget病。 相似文献
108.
109.
S. Wang Y.M. Kirova S.-C. Shan G. Cai D. Ou L. Cao R. Cai J.-Y. Chen 《Cancer radiothérapie》2018,22(8):767-772
Purpose
To evaluate the coverage of different levels of axillary lymph nodes and organs at risk according to the field design of AMAROS study (levels I–II–III–IV), breast tangents with supraclavicular and infraclavicular fields (levels II–III–IV) and high tangent fields to the breast after breast-conserving surgery.Materials and methods
We delineated the axillary lymph nodes levels I–IV in 34 patients treated with breast-conserving surgery and sentinel lymph nodes biopsy. Field design according to AMAROS study – levels I–IV in patients without axillary dissection – as well as irradiation of levels II–IV used in N+ patients after axillary dissection, and also high tangent fields was simulated. Mean dose levels and volumes covered by 95% or 80% isodoses were evaluated. Doses to ipsilateral lung, heart and brachial plexus were compared. Paired t test was used.Results
AMAROS study and levels II–IV plans delivered therapeutic dose to high axilla (levels II–IV), but the high tangent fields showed inefficacy to cover these volumes, P < 0.001). In terms of organs at risk, especially, ipsilateral lung, AMAROS study plan was found to significantly increase the volume receiving at least 10 Gy (I–IV:46.8%, II–IV: 39%), but also the volume receiving at least 20 Gy (I–IV: 39.3%, II–IV: 31.3%), and V30Gy (I–IV: 34.2% vs II–IV: 26.1%), as well as the mean dose (I–IV: 18.6 Gy, II–IV: 15.2 Gy, P < 0.001).Conclusions
The omission of axillary dissection and the axilla irradiation need is associated with high dose irradiation of the lungs, and with higher toxicity. The indication of axillary dissection or irradiation of low axilla could be individualized in relation with individual comorbidities and factors of risk. 相似文献110.
Anand P. Shah M.D. Adam Dickler M.D. Michael C. Kirk Ph.D. Sea S. Chen M.D. Ph.D. Jonathan B. Strauss M.D. Alan B. Coon M.D. Ph.D. Julius V. Turian Ph.D. Kalliopi Siziopikou M.D. Kambiz Dowlat M.D. Katherine L. Griem M.D. 《Medical Dosimetry》2008,33(3):222-225
Partial breast irradiation (PBI) was designed in part to decrease overall treatment times associated with whole breast radiation therapy (WBRT). WBRT treats the entire breast and usually portions of the axilla. The goal of PBI is to treat a smaller volume of breast tissue in less time, focusing the dose around the lumpectomy cavity. The following is a case of a 64-year-old woman with early-stage breast cancer treated with PBI who failed regionally in the ipsilateral axilla. With our dosimetric analysis, we found that the entire area of this axillary failure would have likely received at least 45 Gy if WBRT had been used, enough to sterilize microscopic disease. With PBI, this area received a mean dose of only 2.8 Gy, which raises the possibility that this regional failure may have been prevented had WBRT been used instead of PBI. 相似文献