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Purpose: To investigate lymphatic drainage as measured by lymphoscintigraphy in the arms of patients undergoing either sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND). Material and Methods: From January 2001 to December 2002, 30 patients with unilateral invasive breast carcinoma underwent breast-conserving surgery with SNB and 30 patients with ALND. All patients received radiotherapy to the breast. Lymphoscintigraphy was performed, and skin circulation, skin temperature, and arm volume were measured 2-3 years after radiotherapy. Results: None of the 30 patients who underwent SNB showed any clinical manifestation of lymphedema. Of the 30 patients undergoing ALND, six (20%) had clinical lymphedema, with an arm volume that was >10% larger on the operated than on the non-operated side (P<0.01). Scintigraphically, visual analysis revealed lymphatic dysfunction in three patients, manifested as forearm dermal back flow. Two of these patients also had an increased arm volume. Quantitative analysis showed no differences between the groups, apart from a smaller amount of isotope in the axilla in the ALND group. There was no difference in skin circulation or skin temperature. Conclusion: Our study shows that lymph drainage in the operated arm compared with the non-operated arm was less affected by SNB than by ALND, and that morbidity associated with SNB was lower than with ALND. However, the results do not confirm our hypothesis that lymphoscintigraphy can reveal differences in lymph circulation that are not evident clinically in the form of manifest lymphedema. The most sensitive clinical method of assessing lymph drainage seems to be measurement of arm volume. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the sensitivity of intraoperative frozen section with hematoxyllin-eosin (H&E) staining, immunohistochemistry (IHC) or imprint cytology (IC) in the analysis of sentinel node (SN) in breast cancer.Towards this end, a prospective study of 102 patients undergoing mastectomy or sector resection with SN biopsy was conducted. Frozen sections of SN with H&E, IHC staining and IC had sensitivities of 73.5%, 75.5% and 51.0%, respectively. The combination of H&E and IHC raised the overall sensitivity to 83.7%. Macrometastases (>2 mm) were detected in 100% of the cases with H&E, 92.6% with IHC and 81.5% with IC; and micrometastases (2 mm) in 35.0%, 45.0% and 5.0%, respectively. The combination of H&E and IHC staining raised the sensitivity to 55.0%. Frozen-section analysis with H&E staining showed high sensitivity in detecting macrometastases but not micrometastases. The sensitivity for detection of micrometastases was not substantially increased by the use of intraoperative IHC. Imprint cytology did not provide any additional information. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to compare the sensitivity of intraoperative frozen section with hematoxyllin-eosin (H&E) staining, immunohistochemistry (IHC) or imprint cytology (IC) in the analysis of sentinel node (SN) in breast cancer.Towards this end, a prospective study of 102 patients undergoing mastectomy or sector resection with SN biopsy was conducted. Frozen sections of SN with H&E, IHC staining and IC had sensitivities of 73.5%, 75.5% and 51.0%, respectively. The combination of H&E and IHC raised the overall sensitivity to 83.7%. Macrometastases (>2mm) were detected in 100% of the cases with H&E, 92.6% with IHC and 81.5% with IC; and micrometastases (⩽2mm) in 35.0%, 45.0% and 5.0%, respectively. The combination of H&E and IHC staining raised the sensitivity to 55.0%. Frozen-section analysis with H&E staining showed high sensitivity in detecting macrometastases but not micrometastases. The sensitivity for detection of micrometastases was not substantially increased by the use of intraoperative IHC. Imprint cytology did not provide any additional information. [Copyright &y& Elsevier]

Purpose: To investigate the value of pre-operative contrast-enhanced MR imaging (CE-MRI) in predicting the disease-free and overall survival in breast cancer.Material and Methods: The study population consisted of 50 consecutive patients with histopathologically verified primary breast cancer who pre-operatively underwent CE-MRI examination between 1992 and 1993. A three-time point MR examination was performed where the enhancement rates (C1 and C2), signal enhancement ratio (SER=C1/C2) and washout (W=C1-C2) were calculated. The relation of these MR parameters to disease-free and overall survival was investigated. The median follow-up for surviving patients was 95 months. Univariate and multivariate statistical analyses were performed to evaluate the impact of different factors on prediction of survival.Results: Of the MR parameters examined at univariate analysis, increased C1 (p=0.029), W (p=0.0081) and SER values (p=0.0081) were significantly associated with shorter disease-free survival, and only C1 (p=0.016) was related significantly to overall survival. Multivariate analysis for disease-free survival showed that the SER (p=0.014) and tumor size (p=0.001) were significant and independent predictors. Age (p=0.003), lymph node status (p=0.014), tumor size (p=0.039) and proliferating cell nuclear antigen index (p=0.053) remained independently associated with overall survival at multivariate analysis. C1 was not confirmed as an independent predictor of overall survival.Conclusion: Our findings support the presumption that CE-MRI is useful in predicting the disease-free survival in patients with breast cancer. [ABSTRACT FROM AUTHOR]

Examines the value of dynamic magnetic resonance imaging in diagnosing breast lesions. Evaluation of enhancement kinetics; Observation of dense breast parenchyma; Accuracy of the contrast-enhanced magnetic resonance.

Purpose: The aim of our prospective study was to evaluate the role of planar scintimammography with 99mTc-MIBI in detecting axillary lymph node metastases in women with primary breast carcinoma.Material and Methods: Fifty-eight patients underwent scintimammography rior to axillary lymph node dissection. Ten minutes after injection of 700 MBq 99mTc-MIBI, two prone lateral projections were obtained, followed by a supine anterior projection. Sixty-one axillae (3 bilateral) were operated upon and the status of the lymph nodes verified with histopathology. The scintigraphic result was compared to the histopathologic findings.Results: A sensitivity of 67% and a specificity of 80% of planar scintimammography in detecting axillary lymph node metastases were achieved.Conclusion: Scintimammography with 99mTc-MIBI is not recommended as a routine method for the detection of axillary lymph node metastases in patients with breast carcinoma. [ABSTRACT FROM AUTHOR]

Evaluates the role of planar scintimammography with [sup 99m]Tc-MIBI in the detecting axillary lymph node metastases of breast carcinoma. Status of lymph nodes verified with histopathology; Detection of axillary lymph nodes involvement; Prognostic factors for survival of patients.

Summary Background Postsurgical adhesion formation is still a cause of postoperative morbidity because no satisfactory treatment or prophylaxis has yet been developed. The present study was designed to investigate the influence of the gastrointestinal flora on adhesion formation around surgical anastomoses. Methods Anastomoses were constructed in germfree, conventional, ex-germfree and mono- contaminated rats (Escherichia coli X7 and Lactobacillus acidophilus La5), and adhesion formation was recorded. Results The germfree group had a significantly lower adhesion score than all other groups (P < 0·05) apart from the lactobacillus group, which had a significantly lower score than the conventional group (P < 0·05). Conclusion The bacterial flora of the gastrointestinal tract enhances adhesion formation around surgical anastomoses. [ABSTRACT FROM AUTHOR]