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Objetivo. Nuestro objetivo fue analizar el rendimiento de la biopsia selectiva del ganglio centinela valorando la detección gammagráfica tras la administración intratumoral del radiofármaco en pacientes con cáncer de mama que recibieron quimioterapia neoadyuvante. Material y métodos. Sesenta pacientes con diagnóstico de carcinoma infiltrante de mama, estadios T1-T3, que recibieron tratamiento con quimioterapia neoadyuvante fueron sometidas posteriormente a cirugía mamaria y biopsia del ganglio centinela mediante administración intratumoral del radiofármaco. Resultados. Se consiguió la detección gammagráfica de algún ganglio centinela en 55/60 pacientes (91,6%). Cuando se excluyeron los casos con reinyección periareolar del radiofármaco por falta de migración, la detección fue del 70% (42/60). Cuando se comparó la detección o no del ganglio centinela en estas 42 pacientes, no se encontraron diferencias en función de la edad, lateralidad-localización de la lesión, tamaño pre y posquimioterapia, grado histológico del tumor o perfil inmunohistoquímico. Sí existieron diferencias significativas al comparar los grupos según el grado de respuesta patológica del tumor, valorado tanto con el sistema de Miller-Payne (no detección 44,4%-detección 16,7%, p = 0,003) como con el sistema residual cancer burden (72,2%-28,6%, p<0,01). Conclusiones. La detección gammagráfica del ganglio centinela tras administración intratumoral del radiofármaco en pacientes con cáncer de mama que recibieron quimioterapia neoadyuvante estuvo por debajo del valor óptimo, siendo necesaria en ocasiones la reinyección periareolar, lo que podría estar en relación con una alteración de las vías de drenaje linfático. Existió una significativa relación inversa entre detección del ganglio centinela y el grado de respuesta patológica tumoral (AU)

Purpose. Our objective was to analyse the accuracy of the sentinel node biopsy, taking into consideration the scintigraphy detection rate after the intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy. Materials and methods. The study included 60 patients with a diagnosis of invasive breast carcinoma, stage T1-T3, who received treatment with neoadjuvant chemotherapy, and were subsequently subjected to breast surgery and sentinel node biopsy after intra-tumour administration of the radiopharmaceutical. Results. Scintigraphic detection of some sentinel node was achieved in 55/60 patients (91.6%). When those cases that received a second injection of the radiopharmaceutical, performed peri-areolarly due to a lack of tracer migration, were excluded, the detection rate dropped to 70% (42/60). When the detection of sentinel node, or its absence, was compared in those 42 patients, no differences were found with age, laterality-location of the lesion, size pre- and post-neoadjuvant chemotherapy, histological grade, or immunohistochemical profile. There were significant differences when comparing the groups according to the degree of pathological tumour response, both with the Miller-Payne system (non-detection 44.4%-detection 16.7%, p = 0.003) as well as the residual cancer burden (72.2%-28.6%, p<0.01). Conclusions. The scintigraphic detection of the sentinel node after intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy was below the optimal value, and sometimes a further, peri-areolar, injection was necessary, probably in relation to an alteration in the lymphatic drainage pathways. There was a significant inverse relationship between the detection of the sentinel node and level of pathological tumour response (AU)

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PURPOSE: Our objective was to analyse the accuracy of the sentinel node biopsy, taking into consideration the scintigraphy detection rate after the intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy. MATERIALS AND METHODS: The study included 60 patients with a diagnosis of invasive breast carcinoma, stage T1-T3, who received treatment with neoadjuvant chemotherapy, and were subsequently subjected to breast surgery and sentinel node biopsy after intra-tumour administration of the radiopharmaceutical. RESULTS: Scintigraphic detection of some sentinel node was achieved in 55/60 patients (91.6%). When those cases that received a second injection of the radiopharmaceutical, performed peri-areolarly due to a lack of tracer migration, were excluded, the detection rate dropped to 70% (42/60). When the detection of sentinel node, or its absence, was compared in those 42 patients, no differences were found with age, laterality-location of the lesion, size pre- and post-neoadjuvant chemotherapy, histological grade, or immunohistochemical profile. There were significant differences when comparing the groups according to the degree of pathological tumour response, both with the Miller-Payne system (non-detection 44.4%-detection 16.7%, p = 0.003) as well as the residual cancer burden (72.2%-28.6%, p<0.01). CONCLUSIONS: The scintigraphic detection of the sentinel node after intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy was below the optimal value, and sometimes a further, peri-areolar, injection was necessary, probably in relation to an alteration in the lymphatic drainage pathways. There was a significant inverse relationship between the detection of the sentinel node and level of pathological tumour response.

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La mastopatía diabética abarca una serie de alteraciones estructurales de la glándula mamaria que hace años no estaban bien identificadas y que se describían, junto con otras entidades, bajo un epígrafe común: las llamadas «mastitis granulomatosas». Es una entidad infrecuente, que suele afectar a mujeres premenopáusicas con antecedente de diabetes mellitus tipo 1 de larga evolución. Se trata de una lesión histológicamente benigna, no progresiva y que no predispone a la malignización. Debe considerarse como una complicación crónica adicional de la diabetes de larga duración, al igual que lo son, por ejemplo, la nefropatía diabética o la retinopatía diabética. Conocer su existencia es importante para poder establecer el diagnóstico diferencial con el cáncer de mama. La etiología de la mastopatía diabética no está aclarada, y se invoca cierta asociación con enfermedades autoinmunitarias

Diabetic mastopathy includes a number of structural alterations of breast gland, no well identified since many years and which has been described besides other entities with the name of «granulomatous mastitis». It is an infrequent disease, which affects usually premenopausal women with type 1 diabetes of long duration. It is a benign lesion, non progressive and which will not predispose to breast cancer. The diabetic mastopathy should be considered as an additional chronic complication of diabetes of long duration as diabetic nephropathy, diabetic retinopathy, etc. The major interest remains to establish the differential diagnosis against breast cancer. The etiology of the diabetic mastopathy is not clarified enough, although an association with other autoimmune diseases has been suggested

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A psammomatous endocrine tumor of the duodenum associated with a perforated duodenal ulcer, acute diffuse peritonitis and multiple organ failure is described. Histologic evaluation of the tumor shows a mixed pattern, with solid and glandular structures. Immunohistochemical stains further show cytoplasmic storage of gastrin and somatostatin. Apical CEA staining is also demonstrated in glandular areas of the tumor.

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