Background: Radiothermometry (RTM) is a breast examination method that permits, besides visualization of the pathological foci, to evaluate the quality of metabolism, which is important for the determination of the biological subtypes of breast cancer (BC) and the possibility of the evaluation of the degree of tumor aggressiveness before immunohistochemical analysis. Aim: To study the potentials of modern RTM in the differential diagnosis of benign and malignant breast pathologies and in different biological subtypes of BC. Materials and methods: Overall, 118 patients with different breast pathologies were examined using РТМ 01 РЭС computerized diagnostic complex. Measurements were performed in nine points: directly on the breast ― for the visualization of tumor, in two control points (in the region of the epigastrium and sternal xiphoid process), and in one point in the axillary zone on both sides ― for the identification of probable metastases. The examination time was 1520 min for each woman. RTM results were compared with histological, ultrasound, mammographic, and clinical data. Results: The sensitivity and accuracy of RMT in the differential diagnosis of breast pathology were 96.9% and 74.5%, respectively. The specificity of RTM in the differentiation of aggressive and non-aggressive BC subtypes appeared to be low at 6.6%. In the evaluation of the temperature difference between the pathological and normal tissues, a tendency to a non-increase in the temperature above the tumor in comparison with the unaffected tissue was noted; however, no significant differences between the mean values for the healthy and affected breasts were obtained. No correlations were found between the proliferative index of BC and frequency of thermoasymmetry or extent of its evidence (r 0.3). Conclusion: RTM demonstrated effectiveness in the differential diagnosis of benign and malignant alterations of the breast; thus, it is not a method of choice in the evaluation of the spread and biological subtype of BC.
Comorbid pathology is important in the survival of patients with breast cancer. The main aim of the present study was to investigate prognostic criteria of the 5-year survival menopausal women with breast cancer, including both the classic criteria (age, tumor size, lymph node status, hormonal status) and the presence of comorbid pathology (arterial hypertension, visceral obesity, diabetes mellitus, metabolic syndrome, immunodeficiency). A prospective cohort study included 98 patients with breast cancer (aged 63 ± 9 years, BMI 31.6 ± 4.8 kg/m2). Criteria favorable short-term (5 years) of the cancer prognosis of breast cancer in menopausal women are the size of the tumor less than 5 cm, the absence of metastases in regional lymph nodes, and the absence of the metabolic syndrome, dyslipidemia, high activity of suppressor cells. Age, anthropometric indices (BMI, waist circumference etc.), presence of arterial hypertension do not give information about the 5-year survival rate in breast cancer.
25Радикальная мастэктомия, являющаяся основным методом лечения рака молочной железы, в более 30% случаев приводит к развитию сложного симптомоком-плекса -постмастэктомического синдрома (ПМЭС). Течение ПМЭС отличается разнообразием симптомов и клинических форм, манифестацию можно разделить на местные осложнения и системные нарушения. Местные проявления синдрома -это лимфорея и болевой син-дром, постмастэктомический дефект, постмастэктомиче-ский отек, ограничение амплитуды движений в плечевом суставе, брахиоплексопатия [1]. К системным нарушени-ям относят психоэмоциональные и снижение качества жизни [2]. Полиморфизм манифестации ПМЭС опреде-ляет многоплановость и вариабельность методов иссле-дования послеоперационных осложнений [1,3]. Превен-тивные методики в основном направлены на снижение риска и выраженности одного из проявлений, например лимфореи, но не на весь симптомокомплекс [4]. Одной из методик полифокального характера является ради- Цель -изучение функциональных результатов радикальной мастэктомии с сохранением головной вены и торакоакроми-ального сосудисто-нервного пучка. Материал и методы. Обследованы 140 женщин, перенесших радикальную мастэкто-мию в период с 2008 по 2010 г., 69 из них -с сохранением головной вены и торакоакромиального сосудисто-нервного пучка, 70 пациенток -классическую мастэктомию. Изучены следующие параметры: отек верхней конечности, постма-стэктомическая брахиоплексопатия, нарушение флебогемодинамики, ситуативная тревожность, качество жизни. Резуль-таты. Радикальная мастэктомия с сохранением головной вены и торакоакромиального сосудисто-нервного пучка показала достоверно лучшие функциональные результаты: меньшую частоту отека руки (р=0,018), менее выраженную неврологи-ческую симптоматику (р<0,05), лучшие показатели флебогемодинамики, ситуативной тревожности и качества жизни. За-ключение. Способ радикальной мастэктомии с сохранением головной вены и торакоакромиального сосудисто-нервного пучка демонстрирует лучшие результаты относительно стандартной модификации и может быть выбран вариантом хирур-гического лечения рака молочной железы. Ключевые слова: постмастэктомический синдром, радикальная мастэктомия, функциональные результаты, ультразвуко-вая диагностика, качество жизни.Objective -to study the functional results of radical mastectomy with the retention of the cephalic vein and thoracoacromial neurovascular bundle. Subjects and methods. Examinations were made in 140 women who had undergone radical mastectomy in 2008 to 2010 with the retention of the cephalic vein and thoracoacromial neurovascular bundle in 69 patients of them; 70 patients had classical mastectomy. The following parameters: upper extremity swelling, postmastectomy brachial plexopathy, phlebohemodynamic impairment, situational anxiety, and quality of life were studied. Results. Radical mastectomy with the retention of the cephalic vein and thoracoacromial neurovascular bundle showed significantly better functional results: lower incidence of arm swelling (p=0.018), less pronounced neurological symptoms (p<0.05), an...
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