Sentinel lymph node biopsy in the surgical treatment of initial breast cancer has been increasingly adopted to assess axillary status as a way to replace total lymphadenectomy. The sentinel lymph node can be identified using coloring agents or radiopharmaceuticals. In Brazil, patent blue is the most used dye for this type of procedure, with high rates of identification and safety; however, in some cases, the use of this substance can lead to the occurrence of anaphylactic reactions. The case presented here refers to a 41-year-old female patient admitted for a surgical procedure for total mastectomy associated with sentinel lymph node biopsy with patent blue. After surgical initiation, the patient developed severe anaphylactic shock, staying 21 days in the intensive care unit (ICU) for recovery. Most anaphylactic reactions that occur in the transoperative period are mediated by IgE antibodies, resulting in the degranulation of mast cells and basophils, with the release of mediators such as histamine, prostaglandins, proteoglycans, and cytokines, leading to the clinical manifestations of anaphylaxis. There is evidence that part of the population is allergic to patent blue, and may present with manifestations ranging from hives and pruritus to severe cardiovascular collapse, requiring hospitalization in an ICU. The purpose of this article was to report a case of severe anaphylactic reaction to patent blue and to review the literature regarding this infrequent and potentially serious situation.
Hereditary breast cancer is a complex and important condition, representing about 10% of all breast cancer cases. Identifying highrisk patients and possible carriers of pathogenic genetic variants with indication for genetic testing is an essential step to care for these patients and their families. Treatment can be influenced, both surgical and adjuvant, by the existence of mutation, providing the possibility of better results and preventive measures. In Brazil, access to oncogeneticists and genetic counseling is limited. Mastologists and their teams must be trained to identify and conduct the approach of these patients, with the objective of offering an adequate and preventive care, as well as early diagnostics. In the present study, a literature review of hereditary breast cancer aspects, diagnostic, and implications, in patients with and without breast cancer, was performed, aiming to assist in the proper management offered by mastologists, considering general and Brazilian characteristics.
Descritores Neoplasias da mama Recidiva local de neoplasia Metástase linfática Excisão de linfonodo Doenças linfáticas Keywords Breast neoplasms Neoplasm recurrence, local Lymphatic metastasis Lymph node excision Lymphatic diseasesABSTRACT Axillary contralateral lymph nodes recurrence is uncommon after curative breast cancer treatment. When the contralateral axilla is involved in a woman with a breast cancer history, the diagnostic and correct approach are a dilemma. Although it is traditionally considered a distant event, many studies have shown that aberrant lymph drainage is common after previous breast surgery. This might indicate that axillary contralateral lymph nodes recurrence is a regional event. Therefore, its treatment should be with curative rather than palliative intent. The aim of this article was to report the case of a young woman with invasive carcinoma in the left breast and a posterior axillary contralateral recurrence, and to review the literature about this infrequent and controversial issue.
Introduction: Breast cancer is associated with high frequency and mortality in Brazilian women. There have been limited studies portraying the characteristics of breast cancer cases in the countryside of the state of Minas Gerais for a long period of time, a fact that will allow us to better understand the epidemiology of these tumors. This descriptive study aims to analyze the epidemiology and clinical features of patients with breast cancer treated at a public health service facility in Lavras, MG. Methods: This is a transversal study with 299 women diagnosed with breast cancer between 2002 and 2022, based on data collection from medical records and subsequent descriptive analysis. Results: There were a total of 317 cases, and 299 were eligible for the study. The mean age at diagnosis was 54.2 years, and 36.1% of the patients were under 50 years old at diagnosis. Positive family history was found in 17.0% of the patients. The diagnosis was made by clinical alteration detected on physical examination in 71.5% of cases, and lump was the most frequent type of lesion (89.0%). Invasive carcinoma was 93.1% of the cases, and the mean tumor size was 28.6 mm. The average time between first medical appointment and diagnosis was 63.2 days, and between diagnosis and beginning of treatment was 39.6 days. Conclusions: This study showed that a significant number of cases occurred in women outside the recommended age for screening in Brazil. Diagnosis was predominantly performed by clinical examination, with delays in obtaining the histological diagnosis, and the stage at diagnosis was high, and these facts were associated with the health system limitations. KEYWORDS: breast neoplasm; age groups; cancer screening.
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