Introduction: In cancer cases, surgery is the effective treatment for removing the mass and evaluating the locoregional lymph nodes. The extension of lymph node dissection (LND) is a challenging question in cancer surgery. At present, limited lymph node dissection is a high topic accepted in breast cancer surgery. It is interesting to know that with limitations in lymph node dissection in breast cancer surgery, there are no animal studies on this topic. So, this study investigated local management with and without lymph node dissection on the overall survival (OS) of mice inducted with 4T1 breast cancer cells. Material & methods: Fifty-four inbred female Balb/C mice were divided into seven groups, except for group seven as the healthy control group; all were injected with 4T1 breast cancer cells. Ten (early diagnosis and management) and twenty days(late diagnosis and management) following injection, in groups 1 and 2, the leg was amputated above the knee; in groups 3 and 4, inguinal LND was done without amputation (AMP). In group five, the combination of AMP and LND was performed. Group six was only injected with tumor cells, and group seven was left intact without intervention. Finally, metastasis and survival time was evaluated. Results: Survival time in group 1, group 2 (local Management), and group 5 was significantly higher compared to the control group (P<0.005). Also, Group 1 had longer survival time than in group 2 (early local management better than delayed local management) and group 5 (P=0.018). AMP treatment significantly reduces the amount of breast tumor cell metastasis (P<0.002), while LND does not affect metastasis. Also, simultaneous treatment of leg AMP and LND reduces the metastasis rate of breast tumor cells (P<0.05). Conclusion: In solid tumors, the most effective step is removing cancer (local management) as soon as possible. Evaluating the regional lymph nodes is the next step. Lymph nodes should be removed if tumors involve lymph nodes. However, removing negative lymph nodes will not affect OS. More investigations are recommended in this field.
Introduction: Abnormal uterine bleeding (AUB) is one of the most common symptoms of endometrial cancer that necessitates endometrial biopsy. Objectives: This study aimed to compare the cytological and histological findings in endometrial specimens among women with AUB in three different menstrual groups (pre-menopause, perimenopause, and post-menopause) and to evaluate the statistical accuracy of cytology compared to histopathology (gold standard). Patients and Methods: This descriptive study was conducted on 78 women with AUB admitted to the gynecology and obstetrics unit of Shahid Beheshti hospital, Isfahan, Iran from 2018 to 2020. Patients were divided into three groups (pre-menopause, perimenopause, and post-menopause) based on their menstrual condition. Samples were obtained using endometrial curettage and cytobrush and were analyzed by two surgical pathologists. The results were described in four categories: negative, atypical endometrial cells of undetermined significance (AEC-US), atypical endometrial cells encompassing the spectrum of precursors to the malignant endometrial tumor (AEC-PEMT), and positive. Results: Out of 78 samples, 36 (46.2%) were reported negative for epithelial abnormality, 15 (19.2%) were AEC-US, 9 (11.5%) were AEC-PEMT, and 18 (23.1%) were positive for epithelial lesions. There was a significant association between cytological findings and menstrual groups (P = 0.004). Positive results were more frequently reported in the post-menopausal group, whereas negative results were most common in the pre-menopause group. The sensitivity and specificity of cytological evaluation in the pre-menopause, perimenopause and post-menopause groups were 100% and 95% (accuracy: 100%, 95% CI: 0.94-1), 77% and 53%, (accuracy: 62%, 95% CI: 0.40-0.85), and 100% and 34% (accuracy: 41%, 95% CI: 0.20-0.61), respectively. Conclusion: Cytological examination of the endometrium demonstrated high sensitivity in the pre-menopausal and post-menopausal women with AUB and can therefore be used as an efficient and valuable method of screening for endometrial neoplasia.
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