The 21-gene assay, when applied in a consistent manner in early-stage BC, changes treatment recommendations in one-quarter of patients tested.

LC in elderly patients suffering from acute cholecystitis is feasible and effective. It is associated with a higher rate of morbidity unrelated to the surgical site and mortality in elderly compared with younger patients. Stronger selection of elderly patients for surgery is needed.

Laparoscopic repair of gastroduodenal perforations is a safe alternative treatment offering certain significant short-term advantages.

Laparoscopic IH repair is technically feasible and safe in patients with large fascial defects as well as in obese patients. This operation decreases postoperative pain, hastens the recovery period, and reduces postoperative morbidity and recurrence.

This is the 28th case reported in the literature of Sister Mary Joseph's nodule originating from endometrial carcinoma and the first case of Sister Mary Joseph's nodule originating from endometrial carcinoma incidentally detected during surgery for umbilical hernia. Surgeons should be aware of the possibility of Sister Mary Joseph's nodule coexisting with an umbilical hernia.

Laparoscopic appendectomy is an acceptable procedure for complicated appendicitis, with the same rate of infectious complications as the conventional approach.

We present the clinicopathologic features and treatment plans of 328 consecutive stage I (T1N0M0) breast cancer patients seen at a regional medical center in Israel. Predicted 10-year mortality risk was calculated using the Adjuvant! Online website. The 21-gene recurrence score (RS) (OncotypeDx) was obtained on a minority of patients. Eighty-nine per cent of patients had estrogen receptor (ER) and/or progesterone receptor (PgR) positive tumors. In 43.3% of patients history of an invasive malignancy was reported in a first degree relative and in 15.5% specifically breast and/or ovarian cancer was reported. Chemotherapy was added to endocrine therapy in 59 ER/PgR positive patients, decreasing predicted 10-year mortality risk by a median of 1.8%. Individualized risk estimation by genetic analysis may further decrease the use of chemotherapy in stage I patients. Breast cancer screening may provide an opportunity to identify cancer prone families.

In this article, we describe a modified technique for laparoscopic ventral hernia repair that is easy to perform and teach. The three-keyhole process comprises two major steps: laparoscopic appreciation of the outlet dimension of the hernia and pin-tucking an appropriately sized polytetrafluoroethylene patch after the smooth face has been oriented toward the viscera. We report our experience of 231 patients who underwent the procedure electively between January 1997 and December 2001 with satisfactory results. We suggest that this method be used for all hernia defect-sized elective incisional hernias.