We report two rare cases of breast cancer in men treated with modified radical mastectomy. The patients were aged 67 and 45 years at the time of diagnosis. Tumor sizes were 2 cm and 8 cm in the older and younger patient, respectively. The histopathologic diagnosis was infiltrating ductal carcinoma in the first patient and infiltrating papillary carcinoma in the second patient. Immunohistochemical tests demonstrated estrogen and progesterone receptor positivity and HER2/c-erbB-2 negativity in both cases. The rarity of these cases is noted, in view of their uncommon occurrence at an early age in men and their immunophenotypic positivity, similar to breast cancer in women.
The Crohn's disease, a form of inflammatory bowel disease, is frequent in women of childbearing age. Its management requires greater attention during pregnancy. We report a case of refractory Crohn's disease in a pregnant patient that evolued to ileocolectomy at puerperium. The literature regarding pregnant patients with Crohn's disease was reviewed, including counseling of patients and investigation of active disease, and the existing data was summarized on the safety of medications used to treat Crohn's disease in pregnancy and breastfeeding.
Introduction:The isolation of lymph nodes less than 4.0 mm in diameter from the fatty tissue of surgical breast cancer specimens through the traditional method of tactile perception is difficult, time consuming and failed the identification of smaller lymph nodes. The reported numbers of lymph nodes detected through this technique vary widely in the literature demonstrating its inappropriateness. The use of fat clearance techniques however may contribute to the isolation of additional nodes, allowing for appropriate pathological staging of the disease.Objective: To evaluate the impact of the use of fat clearance machinery and solutions in the dissection and identification of lymph nodes from axillary dissections of patients with breast cancer.Materials and methods: Fat clearance techniques (cooker, electric spiral, modified Koren clearing solution and formaldehyde-acetic alcohol solution) were applied to 100 breast cancer axillary dissections from males and females with no age restriction over a period of two years (2009-2011).Results: Through the use of fat clearance methods, additional 174 metastases in 564 lymph nodes were found, more than the classical method, from which 449 metastases in 1426 lymph nodes were identified. There was no statistical difference between the fat clearance methods; however the cooker method demonstrated greater efficiency than the modified Koren clearing solution method. Conclusion:The fat clearance methods described here have various advantages over the classical method. These methods are viable, rapid, practical, inexpensive and do not alter the quality of histological analysis or immunohistochemical reactions. The findings show that examination of a minimum of 20 isolated lymph nodes is necessary for optimal identification and diagnosis of lymph node metastases. The main outcome from this study were the immediate benefits generated by adopting new technical procedures resulting in a change in pathological staging classification in 14% of the patients.
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