nipple discharge, ulceration of nipple or skin, fixation to skin, fixation to muscle, breast pain and axillary adenopathy. Low incidence, early metastasizing changes, due to particular anatomic structure of the male gland and a high invasiveness rate to surrounding tissues are factors responsible for a late diagnosis. A histopathological response in case of malignant suspicion should be mandatory. However, poor prognostic expectations in case of lymph nodes, positively (5-year-survival in 17-60% patients after radical mastectomy) account for diagnosis in 50% of the patients. Breast cancer in men is more frequently hormone receptor positive than in women and may be more sensitive to hormonal therapy. Optimal management of breast cancer in men is unknown because the rarity of the disease precludes large randomized trials.A 58-year-old man came to the Mastology Program at Hospital das Clínicas, Federal University of Goiá s, in November 2007, with a complaint of a palpable painless nodule located in the left breast for 4 years. On physical examination with palpation of the left breast, a hard mobile nodule with well-defined limits and a regular surface was found, with slight skin thickening around the site. There was no nipple discharge and no palpable lymph nodes. The right breast did not present any abnormalities. Imaging examination was performed using ultrasound and mammography showed a suspicious lesion (Figs. 1 (a) (b) Figure 2. (a and b) Histopathological examination of the skin biopsy reveals dermal infiltration by malignant pleomorphic epithelial cells. The latter are positive with cytokeratin, estrogen, and progesterone receptors, indicating their breast origin. (a) massive dermal infiltration by malignant cells. (b) prominent nuclear pleomorphism with mitosis.
Introduction: There are multiple options available for closing surgical incisions. This study compared the cosmetic results between the use of 2-octylcyanoacrylate and nylon sutures in elective breast surgery. Objectives: To compare the efficacy and cosmetic outcome between the adhesive and conventional suturing with nylon on the cutaneous synthesis mammary surgeries. Methods: we performed a prospective, randomized, controlled trial with 79 patients, 37 in group 2-octylcyanoacrilate and 42 in the group with nylon suture. We evaluated the surgical aspect of the scar in 40 and 180 days, the occurrence of complications (such as dehiscence, hematoma, infection and allergic reactions), the size of the wound and breast lesions, surgical time and skin closure time, hemoglobin and preoperative WBC, age, height and weight of patients. Statistical analysis was performed by t test and chi-square. Results and discussion: the study was stopped before the end of the recruitment of patients for the presence of a greater number of dehiscence in the adhesive group (OR: 11.42, 95% CI 1.36 - 96.02, p=0.007). There were no significant differences between the groups regarding other complications, not in relation to surgical time and the aesthetic appearance of scars after 40 and 180 days. The average size of the wound was greater in the adhesive group than in the suture, being respectively 32.97 (+ 10.54) mm and 27.64 (+ 9.56) mm, no correlation of size with the largest number of dehiscence. Conclusion: The results showed that the cosmetic scar appearance of 2-octylcyanoacrilate is equivalent to those obtained with the intradermal nylon suture, but the risk of dehiscence is higher. Citation Format: Ruffo Freitas-Junior, Thiago S Becker, Rosemar MS Rahal, Regis R Paulinelli. Randomized clinical trial comparing 2-octylcyanoacrylate versus intradermic suture with nylon: Similar cosmetic results with different safety profile [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-13-20.
RESUMO Objetivo: avaliar o perfil de segurança e os resultados estéticos do 2-octilcianoacrilato versus sutura intradérmica com fio de nylon em cirurgias mamárias. Métodos: ensaio clínico randomizado, aberto, que avaliou a ocorrência de complicações, como deiscência, hematoma, infecção e reações alérgicas após o uso do 2-octilcianoacrilato ou do fio de nylon. Também foi analisado o tamanho das incisões, o tempo de fechamento da pele e o tempo cirúrgico total. O resultado estético foi avaliado após 40 e 180 dias da cirurgia, por meio da largura média da ferida operatória e por avaliação subjetiva conceitual (ótimo, bom, razoável ou ruim). Resultados: foram incluídas 79 pacientes, sendo 37 no grupo 2-octilcianoacrilato e 42 no grupo de sutura com fio de nylon. O estudo foi interrompido antes do término do recrutamento dos pacientes pela ocorrência de maior número de deiscências no grupo do adesivo (OR: 11,42; IC95%: 1,36-96,02; p=0,007). Em relação às demais complicações analisadas, ao tempo cirúrgico e ao resultado estético no pós-operatório, não se observaram diferenças significativas entre os grupos. A média do tamanho da ferida operatória foi maior no grupo do adesivo em relação ao grupo da sutura, mas não houve correlação entre o tamanho da ferida e o maior número de deiscências. Conclusão: o 2-octilcianoacrilato apresentou maior risco de deiscência em relação à sutura intradérmica, com resultados estéticos equivalentes.
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