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Newer adjuncts in breast conservation surgery are striving for more precise excision of these cancerous lesions. This study evaluates two such techniques, preoperative ultrasound-guided lesion clipping and skin marking, and their effects on the surgical outcomes of early breast cancer lesions undergoing breast conservation surgery. This retrospective study includes 56 consecutive patients with non-palpable (upfront or post-neoadjuvant chemotherapy) biopsy-proven early breast cancers (T1, T2, T3 lesions). These patients underwent breast conservation surgery using ultrasound-guided percutaneous clipping and skin marking techniques at Manipal Comprehensive Cancer Center, between January 2019 and May 2021. Post excision, their total specimen volume and tumor volume were studied. Of the total of 56 patients, based on institutional protocol, 33 were clipped before neoadjuvant chemotherapy, and 23 patients underwent skin marking. Mean specimen volume was 99.25 ± 60 cm3, and mean tumor volume was 7.38 ± 13.6 cm3. Forty-seven patients (84%) were managed with a simple local type I oncoplastic procedure. In nine patients (16%), local perforator-based flap reconstruction was done. These techniques help to achieve precise excision of these tumors, requiring a lower volume of resection to achieve negative margins, with better cosmetic outcomes.

Literature reported, 9–17% transient ischemic attack (TIA) patients have a vascular event within 90 days, but there is limited data on long-term risk involvement of vascular events following TIA. To identify prevalence and association of cardiovascular diseases (CVD) and cerebrovascular disorders (CeVD) among early and late transient ischemic attack (TIA) patients among US hospitalizations. We performed a retrospective cross-sectional analysis of Nationwide Inpatient Sample (2016–2017) in adults’ hospitalizations. Early TIA (primary diagnosis), late TIA (secondary diagnosis), and vascular events including CVD (atrial fibrillation (Afib), ischemic heart disease (IHD), angina, acute myocardial infarction (MI)) and CeVD (acute ischemic stroke (AIS), intracerebral hemorrhage (ICeH), and subarachnoid hemorrhage (SAH)) among TIA were identified using ICD 10 CM codes. Prevalence of vascular events was compared among patients with TIA and without TIA. Weighted analysis to account for sampling strategy using mixed-effect multivariable survey logistic regression was performed to evaluate odds of having vascular events among TIA in comparison with non-TIA. Among 71,473,874 US hospitalizations, 0.38% and 5.92% patients had early and late TIA, respectively. Patients with late TIA had a higher prevalence of acute MI (4.9 vs 0.5 vs 3.4%), IHD (44 vs 28.6 vs 20.6%), angina (0.3 vs 0.2 vs 0.2%), Afib (22 vs 15.3 vs 10.9%), AIS (5.3 vs 0.6 vs 2%), SAH (0.2 vs 0.03 vs 0.1%) and ICeH (0.8 vs 0.04 vs 0.4%) compared with early TIA and no-TIA, respectively (p < .0001). Patients with late TIA had 23% higher risk of having Afib (aOR 1.23; 95% CI 1.22–1.23) and higher odds of having IHD (1.52; 1.52–1.53), AIS (1.72; 1.70–1.74), and ICeH (1.29; 1.25–1.33). We found a higher prevalence and risk of vascular events in patients with late TIA among US hospitalizations. Hence, a thorough clinical investigation and long-term follow-up of TIA patients may mitigate the risk of future vascular events and associated health care burden.