RESUMEN
BACKGROUND: The axillary nodal status is essential to determine the stage of disease at diagnosis. Our aim was to prospectively assess the diagnostic accuracy of ultrasonography-guided fine-needle aspiration (US-FNA) for the detection of metastasis in axillary lymph nodes in patients with breast cancer (BC) and its impact on the therapeutic decision. MATERIALS AND METHODS: Ultrasonography (US) was performed in 407 axillae of 396 patients who subsequently underwent surgery. US-FNA was conducted when lymph nodes were detected by US. Axillary dissection (AD) was performed when US-FNA was positive for metastasis. Patients with negative US-FNA and breast tumors of 30 mm in size were candidates for selective sentinel lymph node biopsy (SLNB). The anatomopathological results of AD or SLNB were used as reference tests. RESULTS: Lymph nodes were detected by US in 207 (50.8%) axillae. Of these, US-FNA was performed on 180 (86.9%). 94 axillae (52.2%) were positive for carcinoma and 79 women received AD. US-FNA had 77.5% sensitivity, 100% specificity, 100% positive predictive value, 69.3% negative predictive value, and 85.1% diagnostic accuracy. US-FNA avoided SLNB in 18.1% of patients who underwent AD. CONCLUSIONS: Axillary US-FNA is an accurate technique in the staging of patients with BC. It allows reducing the number of SLNB and, when positive, offers a fast and useful tool.
Asunto(s)
Neoplasias de la Mama/etiología , Mamoplastia/métodos , Aceites de Silicona/efectos adversos , Adulto , Implantes de Mama , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Femenino , Humanos , Mamografía , Aceites de Silicona/administración & dosificaciónAsunto(s)
Neoplasias de la Mama Masculina/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama Masculina/metabolismo , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/terapia , Carcinoma Ductal de Mama/epidemiología , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/patología , Carcinoma Ductal de Mama/terapia , Carcinoma Papilar/epidemiología , Carcinoma Papilar/metabolismo , Carcinoma Papilar/patología , Carcinoma Papilar/terapia , Quimioterapia Adyuvante , Europa (Continente)/epidemiología , Humanos , Metástasis Linfática , Masculino , Mastectomía/estadística & datos numéricos , Mastectomía Segmentaria/estadística & datos numéricos , Persona de Mediana Edad , Radioterapia Adyuvante , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Encuestas y CuestionariosRESUMEN
Las hernias paraduodenales son una causa rara de obstrucción intestinal. La variedad derecha, la menos frecuente, se origina en un defecto de la rotación y migración del intestino medio durante el desarrollo embrionario, que lleva a situar gran parte de yeyuno e íleon a la derecha de la columna, por detrás del mesocolon ascendente y transverso. Presentamos un caso de un paciente con esta alteración y describimos los mecanismos embrionarios que la provocan y los signos radiológicos que permiten su diagnóstico prequirúrgico. (AU)