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Aims: Breast cancer is one of the most common cancer diseases in women, with >1.67 million cases being diagnosed worldwide each year. In breast cancer, the sentinel lymph node (SLN) pinpoints the first lymph node(s) into which the tumour spreads, and it is usually located in the ipsilateral axilla. In patients with no clinical signs of metastatic disease in the axilla, an SLN biopsy (SLNB) is performed. Assessment of metastases in the SLNB, when using a conventional microscope, is performed by manually observing a metastasis and measuring its size and/or counting the number of tumour cells. This is done essentially to categorize the type of metastasis as macrometastasis, micrometastasis, or isolated tumour cells, which is used to determine which treatment the breast cancer patient will benefit most from. The aim of this study was to evaluate whether digital image analysis can be applied as a screening tool for SNLB assessment without compromising the diagnostic accuracy. Materials and results: Consecutive SLNBs from 135 patients with localized breast cancer receiving surgery in the period February to August 2015 were collected and included in this study. Of the 135 patients, 35 were received at the Department of Pathology, Rigshospitalet, Copenhagen University Hospital, 50 at the Department of Pathology, Zealand University Hospital, and 50 at the Department of Pathology, Odense University Hospital. Formalin-fixed paraffin-embedded tissue sections were analysed by immunohistochemistry with the BenchMark ULTRA Ventana platform. Rigshospitalet used a mixture of cytokeratin (CK) 7 and CK19, Zealand University Hospital used pancytokeratin AE1/AE3 and Odense used pancytokeratin CAM5.2 for detection of epithelial tumour cells. Slides were stained locally. SLNB sections were assessed in a conventional microscope according to national guidelines for SLNBs in breast cancer patients. The immunohistochemically stained sections were scanned with a Hamamatsu NanoZoomer-XR digital whole slide scanner, and the images were analysed with Visiopharm's software by use of a custom-made algorithm for SLNBs in breast cancer. The algorithm was optimized to the CK antibodies and the local laboratory conditions, on the basis of staining intensity and background staining. Conventional microscopy was used as the gold standard for assessment of positive tumour cells, and the results were compared with those from digital image analysis. The algorithm showed a sensitivity of 100% (that is, no false-negative slides were observed), including 67.2%, 19.2% and 56.1% of the slides from the three pathology departments being negative, respectively. This means that, on average, the workload could have been decreased by 58.2% by use of the digital SLNB algorithm as a screening tool. Conclusions: The SLNB algorithm showed a sensitivity of 100% regardless of the antibody used for immunohistochemistry and the staining protocol. No false-negative slides were observed, which proves that the SLNB algorithm is an ideal screening tool for selecting those slides that a pathologist does not need to see. The implementation of automated digital image analysis of SLNBs in breast cancer would decrease the workload in this context for examining pathologists by almost 60%.

Coexistence of breast cancer and tuberculosis is rare. In most cases, involvement by tuberculosis occurs in axillary lymph nodes. We report a case of a 43-years-old patient who had undergone adenomastectomy and left sentinel lymph node biopsy due to a triple negative ductal carcinoma. At the end of adjuvant treatment, the patient had an atypical lymph node in the left axilla. Lymph node was excised, and after laboratory analysis, the diagnosis was ganglion tuberculosis. The patient underwent treatment for primary tuberculosis. The development of these two pathologies can lead to problems in diagnosis and treatment. An accurate diagnosis is important to avoid unnecessary surgical procedures.

Coexistence of breast cancer and tuberculosis is rare. In most cases, involvement by tuberculosis occurs in axillary lymph nodes. We report a case of a 43-years-old patient who had undergone adenomastectomy and left sentinel lymph node biopsy due to a triple negative ductal carcinoma. At the end of adjuvant treatment, the patient had an atypical lymph node in the left axilla. Lymph node was excised, and after laboratory analysis, the diagnosis was ganglion tuberculosis. The patient underwent treatment for primary tuberculosis. The development of these two pathologies can lead to problems in diagnosis and treatment. An accurate diagnosis is important to avoid unnecessary surgical procedures. A coexistência de câncer de mama e tuberculose é rara. Na maioria das vezes, o acometimento pela tuberculose ocorre nos linfonodos axilares. Relatamos caso clínico de paciente de 43 anos submetida à adenomastectomia e à biópsia de linfonodo sentinela à esquerda devido a um carcinoma ductal triplo negativo. Ao final do tratamento adjuvante, a paciente apresentou linfonodomegalia atípica em axila esquerda. Foi realizado exérese do linfonodo e, após análises laboratoriais, diagnosticou-se tuberculose ganglionar. A paciente foi submetida a tratamento para tuberculose primária. O desenvolvimento dessas duas patologias pode acarretar problemas quanto ao diagnóstico e ao tratamento. O diagnóstico acurado é importante para evitar procedimentos cirúrgicos desnecessários.

OBJECTIVE: To assess the results of palmar and axillary hyperhidrosis treatment in males and females using low doses of oxybutynin. METHODS: A retrospective analysis was conducted in 395 women and 170 men followed up in our service with complaint of palmar and axillary hyperhidrosis. RESULTS: A total of 70% of patients in both groups presented partial or great improvement in the level of hyperhidrosis after treatment. The best results were obtained in the female group, in which 40% classified their improvement as "great". Approximately 70% of the patients in both groups improved their quality of life after medical therapy and 30% presented no change in condition. CONCLUSION: Gender is not a factor that significantly interferes in oxybutynin treatment results. Quality of life indices and clinical improvement level were similar in men and women. OBJETIVO: Avaliar os resultados do tratamento com baixas doses de oxibutinina em homens e mulheres com hiperidrose palmar e axilar. MÉTODOS: Análise retrospectiva de 395 mulheres e 170 homens acompanhados em nosso serviço com queixa de hiperidrose palmar e plantar, submetidos a um protocolo de 12 semanas de tratamento com oxibutinina. Melhora clínica da hiperidrose e da qualidade de vida foram estudadas por meio de um questionário específico, aplicado antes e após o tratamento. RESULTADOS: Dentre os pacientes em ambos os grupos, 70% apresentaram melhoria parcial ou grande no nível de hiperidrose após o tratamento. Os melhores resultados foram obtidos no grupo feminino, no qual 40% classificaram sua evolução como "ótima". Aproximadamente 70% dos pacientes em ambos os grupos melhoraram sua qualidade de vida após a terapia médica e 30% não apresentaram mudança da condição inicial. CONCLUSÃO: Gênero é um fator que não interfere significativamente nos resultados do tratamento com oxibutinina. Os índices de qualidade de vida e o grau de melhora clínica da hiperidrose foram semelhantes em homens e mulheres.

Coexistence of breast cancer and tuberculosis is rare. In most cases, involvement by tuberculosis occurs in axillary lymph nodes. We report a case of a 43-years-old patient who had undergone adenomastectomy and left sentinel lymph node biopsy due to a triple negative ductal carcinoma. At the end of adjuvant treatment, the patient had an atypical lymph node in the left axilla. Lymph node was excised, and after laboratory analysis, the diagnosis was ganglion tuberculosis. The patient underwent treatment for primary tuberculosis. The development of these two pathologies can lead to problems in diagnosis and treatment. An accurate diagnosis is important to avoid unnecessary surgical procedures.

The use of a sentinel lymph node procedure (SN) in various cancer treatments including breast cancer is well examined. Little is known however, regarding the use of SN in colorectal cancer treatment. In this review, we explain the use of SN and its implications for future colorectal cancer treatment.