For women undergoing mastectomy as part of their breast cancer treatment, breast reconstruction is an important part of therapy. However, neoadjuvant, adjuvant treatments as well as other patient-related factors can compromise the results of breast reconstruction techniques. In this article we have reviewed current approaches to the management of complications and risks that neoadjuvant and adjuvant therapies pose on breast reconstruction after mastectomy for breast cancer. Non-treatment related factors influencing reconstruction techniques were reviewed as well.
Introduction: Skin melanoma is estimated for 2% of malignant neoplasms occurring in humans. It is characterized by a high
level of malignancy and low sensitivity to cytostatic drugs. The incidence of skin melanoma increases in Poland. Lymphatic
system is the most common route of dissemination of this neoplasm. The appearance of a sentinel node biopsy technique
has made it possible to identify patients with a regionally advanced disease. It is a minimally invasive method with a small
percentage of complications.
Aim: Analysis of disease free survival (DFS) in cutaneous melanoma patients with sentinel lymph node biopsy.
Material and methods: The analysis included 222 patients with cutaneous melanoma treated in the Department of
Oncological Surgery in 2010–2015, who underwent a sentinel node biopsy. The study group consisted of 136 women and 86
men, the average age of patients was 59 years. Patients were qualified for sentinel node biopsy based on clinical evaluation
and ultrasound of regional lymph nodes. The average follow-up was 25.1 months. About 2 hours before surgery, patients
received the radioisotope, then lymphoscintigraphy SPECT was performed. Additionally, they got the Patent Blue dye in the
operating room.
Results: The sentinel node was identified in 217 patients (98%), and the average sentinel sentinel nodes were 2.25. 27 patients
(12%) had the metastasis in sentinel nodes. In this group, the duration of asymptomatic survival was significantly shorter.
Sentinel node status and age of the patient were independent factors affecting the prognosis of disease free survival.
Conclusions: Sentinel node biopsy is a precise method to identify patients with skin melanoma who have metastasis to
regional lymph nodes and the most important prognostic factor.
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