44 results on '"Scomersi S"'
Search Results
2. Assessment and management of lesions of uncertain malignant potential of the breast at Trieste Breast Unit: a single center experience
- Author
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Scomersi, S., primary, Fezzi, M., additional, Federica, T., additional, Basso, A., additional, Tonutti, M., additional, Ceccherini, R., additional, Zanconati, F., additional, and Bortul, M., additional
- Published
- 2022
- Full Text
- View/download PDF
3. Role of magnetic resonance imaging in managing selected women with newly diagnosed breast cancer
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Scomersi, S., Urbani, M., Tonutti, M., Zanconati, F., and Bortul, M.
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- 2010
- Full Text
- View/download PDF
4. Breast cancer in elderly patients: are we choosing wisely? A critical review of the breast unit of Trieste
- Author
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Giudici, F., primary, Scomersi, S., additional, Coren, T., additional, Tonutti, M., additional, Rizzardi, C., additional, Dell’Antonio, A., additional, Fezzi, M., additional, Dore, F., additional, Ceccherini, R., additional, Schiattarella, A., additional, Milan, V., additional, Zanconati, F., additional, and Bortul, M., additional
- Published
- 2020
- Full Text
- View/download PDF
5. 267 (PB-091) Poster - Assessment and management of lesions of uncertain malignant potential of the breast at Trieste Breast Unit: a single center experience
- Author
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Scomersi, S., Fezzi, M., Federica, T., Basso, A., Tonutti, M., Ceccherini, R., Zanconati, F., and Bortul, M.
- Published
- 2022
- Full Text
- View/download PDF
6. EP-1330 Intraoperative electron radiotherapy (IOERT) boost in early breast cancer: toxicity analysis
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Vidali, C., primary, Pellin, Z., additional, Severgnini, M., additional, Scomersi, S., additional, and Bortul, M., additional
- Published
- 2019
- Full Text
- View/download PDF
7. Analisi delle caratteristiche dei carcinomi d’intervallo e screening detected a 10 anni dall’attivazione del programma di screening mammografico regionale del Friuli Venezia-Giulia nella provincia di Trieste
- Author
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GIUDICI, FABIOLA, BORTUL, MARINA, ARNEZ, ZORAN MARIJ, COVA, MARIA ASSUNTA, RIZZARDI, CLARA, BOTTIN, CRISTINA, SCAGGIANTE, BRUNA, TORELLI, LUCIO, ZANCONATI, FABRIZIO, Tonutti, M., Perulli, A., Assante, M., Cressa, C., Perrone, R., Pravato, M., Makuc, E., Kus, S., Lorusso, A., Gasparini, C., Ober, E., Martellani, F., Biagi, C., Dudine, S., Bonazza, D., Pinamonti, M., Rozze, D., Bellio, G., Scomersi, S., Dell’Antonio, A., Martinolli, S., Renzi, N., Manara, M., Oblak, M., Dore, F., Vidali, C., Ceccherini, R., Dellach, C, Foladore, S., Dudine, L., Malagoli, M., Guglielmi, A., Bonazza, T., Reho, A., Lepre, L., Bradaschia, S., Danieli, L., Gregorich, P, Matarrese, M., Pesavento, V., Coppola, N., Gongolo, F, Franzo, A., Gobbato, M., Clagnan, E., Zanier, L., Delli Quadri, N., Pubblicazione on line, Giudici, Fabiola, Tonutti, M., Bortul, Marina, Arnez, ZORAN MARIJ, Perulli, A., Assante, M., Cressa, C., Perrone, R., Pravato, M., Makuc, E., Kus, S., Lorusso, A., Cova, MARIA ASSUNTA, Gasparini, C., Ober, E., Martellani, F., Rizzardi, Clara, Biagi, C., Bottin, Cristina, Dudine, S., Bonazza, D., Pinamonti, M., Rozze, D., Bellio, G., Scomersi, S., Dell’Antonio, A., Martinolli, S., Renzi, N., Manara, M., Oblak, M., Dore, F., Vidali, C., Ceccherini, R., Dellach, C, Foladore, S., Dudine, L., Malagoli, M., Guglielmi, A., Bonazza, T., Reho, A., Lepre, L., Bradaschia, S., Danieli, L., Gregorich, P, Matarrese, M., Pesavento, V., Scaggiante, Bruna, Torelli, Lucio, Coppola, N., Gongolo, F, Franzo, A., Gobbato, M., Clagnan, E., Zanier, L., Delli Quadri, N., and Zanconati, Fabrizio
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Breast Unit ,Screening Mammografico ,Carcinomi Intervallo - Abstract
l cancro di intervallo (CI) è un’entità patologica che viene descritta solo nell’ambito dei programmi di screening organizzato. Si intende per CI un carcinoma successivo ad un processo di screening negativo e comparso prima del passaggio di screening successivo. Qualsiasi sia la motivazione della loro genesi, i CI rappresentano un insuccesso del programma di screening che, in teoria, mira a diagnosticare tutti i carcinomi in fase di screening, e a non consentire la comparsa di CI. L’analisi dei CI (loro frequenza di comparsa nel tempo, caratteristiche morfologiche e cliniche, revisione della precedente mammografia di screening) è un momento fondamentale della valutazione di performance dello screening.Per questo motivo a 10 anni dall’attivazione del programma di Screening a Trieste, si è voluto confrontare i fattori prognostici dei carcinomi screening-detected (CSD) e dei (CI), alla luce dell’ampio dibattito in letteratura riguardo la maggior aggressività di questi ultimi.
- Published
- 2016
8. Role of lifestyles in breast cancer risk: a retrospective analysis of Trieste's female population
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GIUDICI, FABIOLA, BOTTIN, CRISTINA, BIANCO, Alberto, DI BONITO, LUIGI, ZANCONATI, FABRIZIO, COVA, MARIA ASSUNTA, BORTUL, MARINA, ARNEZ, ZORAN MARIJ, MUSTACCHI, GIORGIO, TORELLI, LUCIO, De Martino S., Martellani F., Ober E., Romano A., Zacchi A., Tonutti m., Gasparini C., Assante M., Frezza F., Bortolotto M. P., Cressa C., Perrone R., Makuc E., Petz G., de Morpurgo P. L., Pellis G., Lizza N., Scomersi S., Dell'Antonio A., Convertino C., Borea B., Renzi N., Dellach C., Franzo A., Zanier L., Giudici, Fabiola, De Martino, S., Bottin, Cristina, Bianco, Alberto, DI BONITO, Luigi, Martellani, F., Ober, E., Romano, A., Zacchi, A., Zanconati, Fabrizio, Cova, MARIA ASSUNTA, Tonutti, M., Gasparini, C., Assante, M., Frezza, F., Bortolotto, M. P., Cressa, C., Perrone, R., Makuc, E., Petz, G., de Morpurgo, P. L., Pellis, G., Lizza, N., Bortul, Marina, Scomersi, S., Dell'Antonio, A., Convertino, C., Borea, B., Renzi, N., Arnez, ZORAN MARIJ, Dellach, C., Mustacchi, Giorgio, Franzo, A., Zanier, L., and Torelli, Lucio
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bmi ,breast cancer ,risk factor ,breast screening program ,smoking risk - Abstract
Friuli Venezia Giulia holds the higest row incidence rate for breast carcinoma in Italy (218%00) and Trieste, where live 125.000 women (105.000 women of age below 75) has the highest incidence rate among the other provinces of the region (220%00). The risk of developing breast carcinoma seems to be correlated with many different factors. The goal of this study is to focus on same specific breast carcinoma risk factors in the Trieste population.
- Published
- 2012
9. Therapeutic strategy for ductal carcinoma in situ patients according to Van Nuys Prognostic Index
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Andretta, M., Scomersi, S., Urbani, M., MARINA BORTUL, Andretta, Michela, Scomersi, Serena, Urbani, Monica, and Bortul, Marina
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Adult ,Medical Records Systems, Computerized ,Breast Neoplasms ,Middle Aged ,Mastectomy, Segmental ,Prognosis ,Carcinoma, Intraductal, Noninfiltrating ,Treatment Outcome ,Risk Factors ,Humans ,Female ,Radiotherapy, Adjuvant ,Neoplasm Grading ,breast ductal carcinoma in situ Van nuys prognostic index ,Mastectomy ,Neoplasm Staging ,Retrospective Studies - Abstract
Evaluation of therapeutic strategy for Ductal Carcinoma In Situ (DCIS) patients at our Brest Cancer Centre and analysis of our pattern of treatment with respect to Van Nuys Prognostic Index (VNPI) cathegories.Our study population is the result of a selection of 85 DCIS patients classified according to the VNPI risk of Local Recurrence (LR). A comparison was made between treatment effectively performed and therapy suggested by VNPI protocols.Out of 53 DCIS women (62%) at low local recurrence risk, 5 patients underwent Breast Conserving Surgery (BCS) alone, 7 were treated with mastectomy and 41 underwent BCS followed by radiotherapy (RT). Out of 31 patients (37%) belonging to VNPI intermediate risk group, 25 cases recived BCS+RT and 6 cases received mastectomy. Only one patient (1%) belonged to VNPI high risk group and underwent mastectomy.Only 31 patients (36,5%) had their definitive treatment according to recommended VNPI criteria, but none of the other 54 cases (63,5%) was undertreated. Performing mastectomy instead of BCS or adding adjuvant radiotherapy at BCS alone were not considered overtreatment because the therapeutic strategy was the result of a multidisciplinary discussion.As DCIS is a heterogeneus desease the one-size-fits-all approach to treatment seems inappropriate. The VNPI was developed in order to help treatment choices, but therapeutic strategies can't be based only on local recurrence risk and need a multidisciplinary approach.Breast cancer, Ductal carcinoma in situ, Van Nuys Prognostic Index.
- Published
- 2014
10. 'Il ruolo della RMN nella determinazione dell’iter diagnostico e terapeutico nel carcinoma mammario in stadio iniziale'
- Author
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Scomersi, S, Bortul, M, Dobrinja, C, Liguori, G, Scomersi, S, Bortul, M, Dobrinja, C, and Liguori, G
- Published
- 2007
11. 'Paratiroidectomia mini-invasiva video-assistita: Iniziale esperienza in un Centro di Chirurgia Generale'
- Author
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Dobrinja, C, Trevisan, G, Scomersi, S, Liguori, G, Dobrinja, C, Trevisan, G, Scomersi, S, and Liguori, G
- Published
- 2007
12. 'La biopsia del linfonodo sentinella nel trattamento chirurgico del carcinoma duttale in situ della mammella: esperienza personale'
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Scomersi S, Bortul M, Dobrinja C, Liguori G, Scomersi, S, Bortul, M, Dobrinja, C, and Liguori, G
- Published
- 2007
13. 'Tiroidectomia mini-invasiva video-assistita: Iniziale esperienza in un Centro di Chirurgia Generale'
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Dobrinja, C, Trevisan, G, Scomersi, S, Liguori, G, Dobrinja, C, Trevisan, G, Scomersi, S, and Liguori, G
- Published
- 2007
14. Evaluation of a breast cancer nomogram for predicting the likelihood of additional nodal metastases in patients with a positive sentinel node biopsy
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Scomersi, S., Torelli, L., Zanconati, F., Tonutti, M., Dore, F., MARINA BORTUL, Scomersi, Serena, Torelli, Lucio, Zanconati, Fabrizio, Tonutti, Maura, Dore, Franca, and Bortul, Marina
- Subjects
Adult ,Aged, 80 and over ,Sentinel Lymph Node Biopsy ,sentinel node ,breast cancer ,Breast Neoplasms ,Middle Aged ,Prognosis ,Nomograms ,Lymphatic Metastasis ,Humans ,Female ,Aged ,Retrospective Studies - Abstract
AIM:Completion axillary lymph node dissection (CALND) performed as a standard procedure after a positive sentinel node biopsy (SLNB) in breast cancer patients results, in almost 40-70% of cases, in no additional positive nodes. A nomogram has been developed at Memorial Sloan Kettering Cancer Center (MSKCC) to predict the likelihood of nonsentinel node metastases (NSLNM) after a positive SLNB. Aim of study was to assess the accuracy of MSKCC nomogram in our community breast cancer population. MATERIAL OF STUDY: From a retrospective database of 276 breast cancer patients we evaluated 62 consecutive cases who underwent CALND after a positive SLNB. Patient and tumor characteristics were collected and the nomogram was used to calculate the probability of NSLNM. The accuracy of MSKCC nomogram was tested by the Receiver Operating Characteristic (ROC) curve. The Area Under the Curve (AUC), sensitivity and specificity were calculated for a 10% cut-off value. RESULTS: Presence of macrometastases (p=0.03) and its extranodal extension (p=0.013) in sentinel node were associated with NSLNM, while other tumor and patient characteristics were not. The accuracy of MSKCC nomogram as measured by AUC was 0.67. The nomogram showed 95% sensitivity and 14% specificity. We revised the nomogram by incorporating the presence of extranodal extension and we obtained a new test with improved specificity (84%). DISCUSSION: The modified predictive model is a useful tool in predicting the likelihood of NSLNM in our cohort of patients and may help decision regarding the need of completion axillary lymph node dissection
- Published
- 2012
15. State of the art in breast intraoperative electron radiation therapy after intraoperative ultrasound introduction
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Vidali Cristiana, Severgnini Mara, Bellio Gabriele, Giudici Fabiola, Milan Vittorino, Pellin Zaira, Savatovic Sara, Scomersi Serena, Fastner Gerd, Ciabattoni Antonella, and Bortul Marina
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breast cancer ,intraoperative electron radiation therapy ,ultrasound ,whole breast radiotherapy ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Breast intraoperative electron radiation therapy (B-IOERT) can be used in clinical practice both as elective irradiation (partial breast irradiation – APBI) in low risk breast cancer patients, and as an anticipated boost. The procedure generally includes the use of a shielding disk between the residual breast and the pectoralis fascia for the protection of the tissues underneath the target volume. The aim of the study was to evaluate the role of intraoperative ultrasound (IOUS) in improving the quality of B-IOERT.
- Published
- 2021
- Full Text
- View/download PDF
16. Clinicopathologic factors predicting involvement of nonsentinel axillary lymphnodes in breast cancer patients: is axillary dissection always indicated?
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Scomersi, S., Pozzo, F. D., Torelli, L., FABRIZIO ZANCONATI, Tonutti, M., Dore, F., Bortul, M., Scomersi, Serena, DA POZZO, Francesca, Torelli, Lucio, Zanconati, Fabrizio, Tonutti, Maura, Dore, Franca, and Bortul, Marina
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Adult ,Aged, 80 and over ,Breast Neoplasms ,Middle Aged ,Prognosis ,sentinel axillary lymphnodes ,statistics ,Lymphatic Metastasis ,Axilla ,Humans ,Lymph Node Excision ,Female ,Aged ,Retrospective Studies ,sentinel axillary lymphnode - Abstract
AIM: The aim of this study was to determine factors that predict non-sentinel axillary lymph nodes (NSLNs) metastases in breast cancer patients with positive sentinel node biopsy (SLNB). MATERIAL OF STUDY: We reviewed the records of a consecutive series of 176 breast cancer patients who underwent SLNB at our institution. From the database we analysed those cases with one or more positive sentinel lymph nodes (SLNs) in order to determine factors predicting NSLN metastases. RESULTS: From a series of 176 consecutive patients, we evaluated 41 cases (23.3%) with positive SLNB. Subsequent completion axillary lymph node dissection (CALND) revealed NSLN metastases in 15 cases (36.6%). The significant variables predictive of NSLN involvement were the presence of macrometastases with extranodal extension (p = 0.048), the presence of more than one positive SLN (p = 0.08) and a ratio between positive SLN and SLNs globally dissected higher than 0.5 (p = 0.05). DISCUSSION: CALND is the gold standard for patients with positive SLNB, but results, in almost 40-70% of cases, in no additional positive nodes and its therapeutic benefit remains controversial. Clinicopathologic factors predictive of NSLN metastases may be useful in identifying a subset of patients with lower risk of further axillary involvement. CONCLUSIONS: In patients with early breast carcinoma and a positive SLNB, the size of SLN metastases, the presence of extranodal extension, more than one positive SLN and a nodal ratio higher than 0.5 are the factors that significantly increase the frequency of additional axillary positive lymph nodes.
- Published
- 2010
17. Amodal completion enhances the discrimination of Vernier offset
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Gerbino, W., primary, Scomersi, S., additional, and Fantoni, C., additional
- Published
- 2010
- Full Text
- View/download PDF
18. 148 Poster - Breast cancer in elderly patients: are we choosing wisely? A critical review of the breast unit of Trieste.
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Giudici, F., Scomersi, S., Coren, T., Tonutti, M., Rizzardi, C., Dell'Antonio, A., Fezzi, M., Dore, F., Ceccherini, R., Schiattarella, A., Milan, V., Zanconati, F., and Bortul, M.
- Subjects
- *
BREAST tumor treatment , *CANCER treatment , *CONFERENCES & conventions , *DECISION making in clinical medicine , *SPECIALTY hospitals , *TREATMENT effectiveness , *OLD age - Published
- 2020
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19. Occult breast cancer during reduction mammoplasty: case report
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Panizzo, N., D Aloja, C., Scomersi, S., giovanni papa, Bortul, M., Arnez, Z. M., N., Panizzo, C., D'Aloja, S., Scomersi, Papa, Giovanni, Bortul, Marina, and Arnez, ZORAN MARIJ
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Incidental Findings ,Macromastia ,Reduction Mammopasty ,Infiltrating lobular carcinoma ,Mammaplasty ,Carcinoma, Ductal, Breast ,Breast Neoplasms ,breast cancer ,Mammography ,Occult breast carcinoma ,Humans ,Female ,Aged - Abstract
AIM: Breast carcinoma occurring in routine reduction mammaplasty is rare. MATERIAL OF STUDY: In our Breast Unit each patient eligible for any breast surgery is routinely evaluated by preoperative breast imaging. We reported the clinical case of a woman with an infiltrating lobular breast cancer detected during surgical reduction mammaplasty despite a negative preoperative bilateral mammography. RESULTS: The clinical case was discussed at multidisciplinary breast cancer meeting in order to evaluate the different therapeutic options. In conjunction with general surgeons, oncologists, radiologists and radiotherapists, and upon patient's ultimate decision, a conservative tumor approach was chosen: first-level axillary node dissection followed by adjuvant chemotherapy and hormonotherapy. DISCUSSION: The mean frequency of breast cancer detection during reduction mammaplasty ranges from 0.06% up to 4%. There are many possible treatment choices for these patients ranging from radical mastectomy to more conservative approaches dealing with lumpectomy followed by radiation therapy or chemotherapy and radiation therapy alone. The therapeutical plan must be discussed by a multidisciplinary team and many tumors and patients characteristics should be evaluated in the decision making process. CONCLUSION: All patients selected for breast aesthetical surgery must be screened, during preoperative workup, for breast cancer. Combination of three diagnostic modalities increases sensitivity and reaches the diagnostic accuracy of 93.2%. The reported case stresses the importance of an oncological approach to breast surgery even in case of planned aesthetical procedures.
20. Neuroendocrine carcinoma of the breast: a rare entity,Carcinoma neuroendocrino della mammella: una rara evenienza
- Author
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Sartori, A., Scomersi, S., Spivach, A., and Vigna, S.
21. Management of the axilla in breast cancer: outcome analysis in a series of ductal versus lobular invasive cancers
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Serena Scomersi, Fabrizio Zanconati, Stephen B. Fox, C Bigal, Silvia Paola Corona, Cristina Bottin, Daniele Generali, Marina Bortul, Fabiola Giudici, Corona, S., Bortul, M., Scomersi, S., Bigal, C., Bottin, C., Zanconati, F., Fox, S. B., Giudici, F., and Generali, D.
- Subjects
0301 basic medicine ,Oncology ,Cancer Research ,Metastasis ,0302 clinical medicine ,Breast cancer ,ALND ,skin and connective tissue diseases ,Mastectomy ,Aged, 80 and over ,medicine.diagnostic_test ,Carcinoma, Ductal, Breast ,Disease Management ,Middle Aged ,Invasive lobular carcinoma ,Prognosis ,Survival Rate ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Surgical management ,Female ,Adult ,medicine.medical_specialty ,Invasive ductal carcinoma ,Sentinel lymph node ,Breast Neoplasms ,Axilla ,03 medical and health sciences ,Young Adult ,Internal medicine ,Biopsy ,medicine ,Humans ,Neoplasm Invasiveness ,Aged ,Retrospective Studies ,business.industry ,Sentinel Lymph Node Biopsy ,Axillary Lymph Node Dissection ,Retrospective cohort study ,medicine.disease ,body regions ,Carcinoma, Lobular ,030104 developmental biology ,Lymph Node Excision ,business ,Follow-Up Studies - Abstract
Introduction: Axillary lymph node dissection (ALND) has been considered essential for the staging of breast cancer (BC). As the impact of tumor biology on clinical outcomes is recognized, a surgical de-escalation approach is being implemented. We performed a retrospective study focused on surgical management of the axilla in invasive lobular carcinoma (ILC) versus invasive ductal carcinoma (IDC). Materials and methods: 1151 newly diagnosed BCs, IDCs (79.6%) or ILCs (20.4%), were selected among patients treated at our Breast Cancer Unit from 2012 to 2018. Tumor characteristics and clinical information were collected and predictors of further metastasis after positive sentinel lymph node biopsy (SLNB) analyzed in relation to disease-free survival (DFS) and overall survival (OS). Results: 27.5% of patients with ILC had ≥ 3 metastatic lymph nodes at ALND after positive SLNB versus 11.48% of IDCs (p = 0.04). Risk predictors of further metastasis at ALND were the presence of > 2 positive lymph nodes at SLNB (OR = 4.72, 95% CI 1.15–19.5 p = 0.03), T3–T4 tumors (OR = 4.93, 95% CI 1.10–22.2, p = 0.03) and Non-Luminal BC (OR = 2.74, 95% CI 1.16–6.50, p = 0.02). The lobular histotype was not associated with the risk of further metastasis at ALND (OR = 1.62, 95% CI 0.77–3.41, p = 0.20). Conclusions: ILC histology is not associated with higher risk of further metastasis at ALND in our analysis. However, surgical management decisions should be taken considering tumor histotype, biology and expected sensitivity to adjuvant therapies.
- Published
- 2019
22. Spontaneous Bladder Rupture after Normal Vaginal Delivery: Description of a Rare Complication and Systematic Review of the Literature
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Nicolò de Manzini, Guglielmo Stabile, Giuseppe Ricci, Serena Scomersi, Giulia Zinicola, Federico Romano, Francesco Cracco, Davide De Santo, Stabile, G., Cracco, F., De Santo, D., Zinicola, G., Romano, F., De Manzini, N., Scomersi, S., and Ricci, G.
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Medicine (General) ,medicine.medical_specialty ,Abdominal pain ,medicine.diagnostic_test ,Spontaneous Bladder Rupture ,Bladder rupture ,Laparoscopy ,Spontaneous ,Systematic review ,Vaginal delivery ,business.industry ,Urinary system ,Clinical Biochemistry ,Spontaneou ,Surgery ,Cystography ,R5-920 ,Oliguria ,Vomiting ,Medicine ,medicine.symptom ,business ,Complication - Abstract
Objective: To identify the possible causes of spontaneous bladder rupture after normal vaginal delivery and to propose a diagnostic and therapeutic algorithm. Material and Methods: MEDLINE (PubMed), Web of Science and Scopus databases were searched up to August 2020. Manuscripts considered were published from 1990 and only English articles were included. The research strategy adopted included the following terms: (bladder rupture) AND (spontaneous) AND (delivery). 103 studies were identified. Duplicates were found through an independent manual screening. Subsequently, two authors independently screened the full text of articles and excluded those not pertinent to the topic. Discrepancies were resolved by consensus. Finally, thirteen studies were included. Results: PRISMA guidelines were followed. For each study, fetal weight, catheterization during labor, parity, maternal age, occurrence time, previous abdominal or pelvic surgery, symptoms complained of, diagnostic methods, and treatment were considered. Median age was 26.0 (range 20–34 years); median presentation time was 3.0 days after delivery (range 1–20 days); and median newborn weight was 3227.0 g (range 2685–3600 g). Catheterization during labor was reported only in four of the thirteen cases (30.8%) identified. The symptoms most frequently complained of were abdominal pain and distension, fever, oliguria, haematuria and vomiting. Instrumental diagnosis was performed using X-rays in five cases and computerized tomography in six cases. Ultrasound was chosen in five cases as a first diagnostic tool. In two cases, cystography was performed. Treatment was always laparotomic repair of the visceral defect. Conclusion: Abdominal pain, increased creatinine and other signs of kidney failure on blood tests should lead to suspicion of this complication. Cystourethrography is regarded as a procedure of choice, but a first ultrasound approach is recommended. The main factor for the therapeutic choice is the intraperitoneal or extraperitoneal rupture of the bladder. Classical management for intraperitoneal rupture of the bladder is surgical repair and urinary rest.
- Published
- 2021
23. The current role of touch imprint cytology in sentinel lymph node intra-operatory examination
- Author
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Fabrizio Zanconati, Marina Bortul, Serena Scomersi, Marina Troian, Cristiana Iacuzzo, Laura Bonadio, Clara Rizzardi, Fabiola Giudici, Deborah Bonazza, Gabriele Bellio, Iacuzzo, C., Scomersi, S., Giudici, F., Bonadio, L., Troian, M., Bellio, G., Rizzardi, C., Bonazza, D., Zanconati, F., and Bortul, M.
- Subjects
medicine.medical_specialty ,touch imprint intraoperative cytology (TIIC) ,Sentinel lymph node ,Breast Neoplasms ,Touch imprint cytology ,Sentinel lymph node (SLN) ,breast cancer ,Sensitivity and Specificity ,Intraoperative Period ,Breast cancer ,Internal Medicine ,medicine ,Humans ,breast cancer, sentinel lymph node, touch imprint cytology ,business.industry ,Sentinel Lymph Node Biopsy ,medicine.disease ,Oncology ,Touch ,Lymphatic Metastasis ,Axilla ,Surgery ,Female ,Radiology ,Lymph Nodes ,Sentinel Lymph Node ,business ,touch imprint cytology - Abstract
N/A
- Published
- 2019
24. Association between benign thyroid disease and breast cancer: A single center experience
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A. Lanzaro, Nicolò de Manzini, Giulia Vallon, Marina Bortul, Fabiola Giudici, Deborah Bonazza, Chiara Dobrinja, Serena Scomersi, A. Romano, Fabrizio Zanconati, Marina Troian, Dobrinja, C., Scomersi, S., Giudici, F., Vallon, Giulia, Lanzaro, Alessio, Troian, M., Bonazza, D., Romano, A., Zanconati, F., De Manzini, N., and Bortul, M.
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Male ,medicine.medical_specialty ,endocrine system ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Breast Neoplasms ,030209 endocrinology & metabolism ,Thyroid Function Tests ,Gastroenterology ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Internal medicine ,medicine ,Humans ,Prospective cohort study ,Thyroid cancer ,Thyroid disorders ,Aged ,Retrospective Studies ,lcsh:RC648-665 ,business.industry ,Research ,Thyroid disease ,Thyroid ,Retrospective cohort study ,General Medicine ,Prognosis ,medicine.disease ,Thyroid Diseases ,medicine.anatomical_structure ,Benign thyroid disease ,Menopause ,030220 oncology & carcinogenesis ,Female ,Thyroid function ,business ,Biomarkers ,Follow-Up Studies - Abstract
Background The relationship between breast cancer (BC) and thyroid disease (TD) is still controversial. The aim of the study was to investigate the possible coexistence of TD in patients with newly diagnosed BC and its correlation with BC clinical presentation with regard to menopausal status and stage of disease. Methods This is a retrospective cohort study of all patients treated for primary BC between 2014 and 2016 at the Breast Unit of Trieste University Hospital. Clinical charts and reports were reviewed for coexisting thyroid disorders (i.e. hyperthyroidism, hypothyroidism, benign TD, thyroid cancer, thyroid autoimmunity) and menopausal status at the time of BC diagnosis. Biomolecular profile, stage, and grading of BC were also evaluated. Results A total of 786 women and 7 men were included in the study. Co-presence of TD was found in 161(20.3%) cases: of these, 151(19.4%) patients presented benign TD and 10(1.3%) patients presented thyroid carcinoma. Thyroid autoimmunity was found in 51(32%) patients. Regarding thyroid function, 88(55%) patients had hypothyroidism, 19(12%) hyperthyroidism, and 54(33%) normal thyroid function. No statistically significant correlation was found between age and TD (p = 0.16), although TD was more common in women aged ≥60 years. Women with BC diagnosed at pre-menopausal age were more likely to have thyroid autoimmune diseases (45% vs. 29%, p = 0.05). No association was detected among BC molecular profiles with either thyroid autoimmunity (p = 0.26) or altered thyroid function (p = 0.63). High-grade BC was more frequent in women with hyperthyroidism (52.9%, p = 0.04), but the grading was independent from the presence of thyroid autoimmune disease (p = 0.87). BC stage was related to both thyroid autoimmunity (p = 0.04) and thyroid function (p Conclusions According our study results, patients with primary BC present a greater incidence of autoimmunity disorders, especially when diagnosed in the pre-menopausal setting. However, further prospective studies are required to definitively prove causality.
- Published
- 2019
25. Amodal completion enhances the discrimination of Vernier offset
- Author
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S. Scomersi, C. Fantoni, W. Gerbino, Vision Science Society, Gerbino, Walter, Scomersi, S, and Fantoni, Carlo
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Communication ,Offset (computer science) ,Computer science ,Vernier scale ,business.industry ,Occlusion ,Amodal perception ,Amodal Completion ,Visual approximation ,Sensory Systems ,law.invention ,Ophthalmology ,law ,Psychophysic ,Psychophysics ,Model ,Computer vision ,Artificial intelligence ,business - Published
- 2006
26. Role of Qualitative and Quantitative Indocyanine Green Angiography to Assess Mastectomy Skin Flaps Perfusion: A Prospective Monocentric Experience.
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Mastronardi M, Fracon S, Scomersi S, Fezzi M, Pellin Z, and Bortul M
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Introduction: Mastectomy skin flap (MSF) necrosis remains a significant complication in breast reconstruction. This study aims to identify a correlation between the qualitative and quantitative analysis of the MSF perfusion grade and the skin necrosis rate 1 month after surgery using indocyanine green angiography (ICGA), focusing on lag time and perfusion metrics., Methods: Consecutive women scheduled for nipple/skin-sparing/skin-reducing mastectomy between May 2020 and October 2022 were prospectively enrolled. Patients were divided into Group 1 in the absence of superficial and full-thickness necrosis (SN; FTN) and Group 2 in the presence of both. Demographic data, lag time T1 (time between ICG injection and the initial perfusion of the least perfused MSF area), ICG-Q1, and ICG-Q% (absolute and relative perfusion values of the least vascularized area) were collected., Results: 76 breasts were considered. FTN was reported in 8 breasts (10.5%) and SN in 4 (5.2%). The 2 groups statistically differ in T1 (Group2 > Group1), ICG-Q1, and ICG-Q% (Group1 > Group2) ( P < 0.05). T1 longer than 170 seconds, body mass index, previous chemo/radiotherapy, arterial hypertension, breast weight, type of surgery, and ICG quantitative values can help in predicting MSF necrosis., Conclusions: MSF qualitative and quantitative perfusion evaluation can be helpful to prevent MSF necrosis. However, it should be considered together with the patient's characteristics, the type of surgery, and T1. In this way, it is possible to predict the risk of MSF necrosis and plan the best reconstructive strategy., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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27. Male breast cancer: a multicenter study to provide a guide for proper management.
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Lissidini G, Nicosia L, Sargenti M, Cucchi MC, Fabi A, Falco G, Gardani M, Grilz G, Maugeri I, Murgo R, Neri A, Pellini F, Sensi C, Scomersi S, Taffurelli M, Bagnardi V, Oriecuia C, Pagan E, Sangalli C, Dessena M, Veronesi P, and Galimberti V
- Abstract
Introduction: To offer an extensive retrospective experience on the management of male breast cancer., Methods: A multicenter retrospective observational cohort study was conducted, including male patients diagnosed with breast cancer (invasive or in situ) in 12 Italian breast units from January 1975 to December 2019. Patients aged 18 years or older were assessed for eligibility. Exclusion criteria were metastatic cancer at diagnosis, previous cancer(s), received neoadjuvant treatment, incomplete data on (neo) adjuvant treatment(s), and/or follow-up data. Data on radiological examinations, demographic characteristics, risk factors, histological features, receptor status, treatments, and follow-up were collected., Results: In a series of 671 male patients with breast cancer assessed for eligibility, 403 (28 in situ and 375 invasive neoplasms) were included in the study. All included patients underwent surgery. The median age at surgery was 63.8 years (IQR 56.1-72.1). In 68% of cases, patients underwent echography, and in 55.1%, a mammography. Most patients were ER and PR positive (63.8%), HER2 negative (80.4%), with high (≥ 20%) Ki67 values (61.3%), and luminal B subtype (51.1%). The 10-year overall survival was 73.6% (95% CI 67.0-79.1) for invasive breast cancer and 90% (95% CI 65.6-97.4) for in situ breast cancer. In patients with invasive breast cancer, at univariable analysis, having a G3 tumor (vs. G1), pT2/3/4 (vs. pT1), pN2/3 (vs. pN0), luminal B subtype with Ki67 ≥ 20% (vs. Luminal A), were significantly associated with a higher risk of death. In multivariable analyses, pT2/3/4 (vs. pT1) remained significantly associated with a higher risk of death (HR 3.14, 95% CI 1.83-5.39), and having a HER2 positive or a triple-negative subtype (vs. Luminal A) was also significantly associated with a higher risk of mortality (HR 4.76, 95% CI 1.26-18.1)., Conclusion: Male breast cancer is a rare disease, the better understanding of which is necessary for a more effective diagnostic and therapeutic approach., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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28. Neoadjuvant systemic treatment in breast cancer surgery: is it always worth it?
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Losurdo P, Fezzi M, Giudici F, Bressan L, Scomersi S, Ceccherini R, Zanconati F, and Bortul M
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Background: Surgeons perspective of breast cancer (BC) treatment has deeply changed in recent time. We investigated survival outcomes of BC patients who underwent Neoadjuvant systemic treatment (NAT) before surgery and to assess the role of NAT in determining possible prognosis., Methods: We retrospectively analyzed a total of 2372 BC patients consecutively enrolled in our prospective institutional database. Seventy-eight patients over 2372 reached the inclusion criteria and underwent surgery after NAT., Results: After NAT, the 50% of luminal-B-HER2+ and the 53% of HER2+ had a pathological complete response (pCR) and only 18.5% of the TNs had a pCR. NAT significantly changed lymph node status (P=0.05). All women with pCR are still alive (No-pCR 0.732 CI: 0.589-0.832; yes-pCR 1.000 CI: 1.00-1.00; P=0.02). The molecular biology of the tumor, after NAT, is strictly related to survival both for 3- and 5-years OS. A triple negative BC have the worst prognosis (HER2+ 0.796 CI: 0.614-1; Luminal-A: 1 CI:1-1; LuminalB-HER2 -: 0.801 CI: 0.659-0975; LuminalB-HER2+: 1 CI:1-1; TN 0.542 CI: 0.372-0789, P=0.002)., Conclusions: We can state that, based on our experience, we can consider safe and effective conservative interventions following neoadjuvant therapy. An adequate selection of patients is crucial. It is also clear how the planning of the therapeutic path plays a key role in an interdisciplinary context. NAT is a source of hope for the future both for the identification of new predictors of prognosis and in the field of research, for the development of new drugs.
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- 2023
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29. Next-Generation Sequencing and Triple-Negative Breast Cancer: Insights and Applications.
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Tierno D, Grassi G, Scomersi S, Bortul M, Generali D, Zanconati F, and Scaggiante B
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- Humans, Mutation, Biomarkers, High-Throughput Nucleotide Sequencing, Triple Negative Breast Neoplasms pathology
- Abstract
The poor survival of triple-negative breast cancer (TNBC) is due to its aggressive behavior, large heterogeneity, and high risk of recurrence. A comprehensive molecular investigation of this type of breast cancer using high-throughput next-generation sequencing (NGS) methods may help to elucidate its potential progression and discover biomarkers related to patient survival. In this review, the NGS applications in TNBC research are described. Many NGS studies point to TP53 mutations, immunocheckpoint response genes, and aberrations in the PIK3CA and DNA repair pathways as recurrent pathogenic alterations in TNBC. Beyond their diagnostic and predictive/prognostic value, these findings suggest potential personalized treatments in PD -L1-positive TNBC or in TNBC with a homologous recombination deficit. Moreover, the comprehensive sequencing of large genomes with NGS has enabled the identification of novel markers with clinical value in TNBC, such as AURKA , MYC , and JARID2 mutations. In addition, NGS investigations to explore ethnicity-specific alterations have pointed to EZH2 overexpression, BRCA1 alterations, and a BRCA2 -delaAAGA mutation as possible molecular signatures of African and African American TNBC. Finally, the development of long-read sequencing methods and their combination with optimized short-read techniques promise to improve the efficiency of NGS approaches for future massive clinical use.
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- 2023
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30. A Case-Control Study by ddPCR of ALU 260/111 and LINE-1 266/97 Copy Number Ratio in Circulating Cell-Free DNA in Plasma Revealed LINE-1 266/97 as a Potential Biomarker for Early Breast Cancer Detection.
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Bortul M, Giudici F, Tierno D, Generali D, Scomersi S, Grassi G, Bottin C, Cappelletti MR, Zanconati F, and Scaggiante B
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- Humans, Female, Case-Control Studies, DNA Copy Number Variations, Quality of Life, Biomarkers, Tumor genetics, DNA, Neoplasm, Polymerase Chain Reaction, Peptide Elongation Factor 1 genetics, Breast Neoplasms diagnosis, Breast Neoplasms genetics, Breast Neoplasms pathology, Cell-Free Nucleic Acids genetics
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Background: In Western countries, breast cancer (BC) is the most common cancer in women. Early detection has a positive impact on survival, quality of life, and public health costs. Mammography screening programs have increased early detection rates, but new approaches to more personalized surveillance could further improve diagnosis. Circulating cell-free DNA (cfDNA) in blood could provide a potential tool for early diagnosis by analyzing cfDNA quantity, circulating tumor DNA mutations, or cfDNA integrity (cfDI)., Methods: Plasma was obtained from the blood of 106 breast cancer patients (cases) and 103 healthy women (controls). Digital droplet PCR was used for the determination of ALU 260/111 bp and LINE-1 266/97 bp copy number ratio and cfDI. cfDNA abundance was calculated using copies of the EEF1A2 gene. The accuracy of biomarker discrimination was analyzed with receiver operating characteristic curve (ROC). Sensitivity analyses were performed to account for age as a potential confounder., Results: Cases had significantly lower ALU 260/111 or LINE-1 266/97 copy number ratios (median; ALU 260/111 = 0.08, LINE-1 266/97 = 0.20), compared with control (median; ALU 260/111 = 0.10, LINE-1 266/97 = 0.28) ( p < 0.001). ROC analysis showed that copy number ratio discriminated cases from controls (area under the curve, AUC = 0.69, 95% CI: 0.62-0.76 for ALU and 0.80, 95% CI: 0.73-0.86 for LINE-1). ROC from cfDI confirmed the better diagnostic performance of LINE-1 compared with ALU., Conclusions: Analysis of LINE-1 266/97 copy number ratio or cfDI by ddPCR appears to be a useful noninvasive test that could aid in early BC detection. Further studies in a large cohort are needed to validate the biomarker.
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- 2023
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31. Central Mound Technique in Oncoplastic Surgery: A Valuable Technique to Save Your Bacon.
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Stocco C, Cazzato V, Renzi N, Manara M, Ramella V, Scomersi S, Fezzi M, Bortul M, Arnez ZM, and Papa G
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- Humans, Female, Retrospective Studies, Quality of Life, Breast pathology, Mastectomy, Segmental methods, Pork Meat, Breast Neoplasms surgery, Breast Neoplasms pathology, Mammaplasty methods
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Introduction: Breast-conserving surgery (BCS) is a valid method for the reconstruction of partial breast defects, however, there is a great variety of final aesthetic outcomes depending on the location of the tumor in the breast and also on the initial breast volume and the degree of ptosis. Specifically, defects affecting the upper inner/central quadrant represent a reconstructive challenge with not always satisfactory final results. For this purpose, the authors investigated the use of the central mound technique in breast-conserving surgery. The aim of the study was to apply the central mound as an oncoplastic technique and assess the satisfaction rate of the patients., Materials and Methods: This was a retrospective study that involved 40 patients (80 breast) underwent breast conserving surgery and contextual bilateral breast remodeling with central mound technique. A pre- and postoperative Breast-Q questionnaire (breast conserving therapy module) was given to all the patients before the surgery, 3 months and 9 months after. The statistical analysis with chi-square test was performed., Results: After 9 months the author found a major increase of all BREAST-Q parameters; the most valuable increments concerned the "Satisfaction with breast" and "Psychosocial well-being." None of the patients experienced a decreased in the quality of life related to the surgical procedure., Conclusion: The authors believe that this technique has useful functional and aesthetic results particularly appreciated by patients with upper pole lesion who have a slightly or moderately breast ptosis and a small cup size., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
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32. Role of Qualitative and Quantitative Indocyanine Green Angiography to Assess Mastectomy Skin Flaps Perfusion in Nipple/Skin-Sparing and Skin-Reducing Mastectomies with Implant-Based Breast Reconstruction.
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Mastronardi M, Fracon S, Scomersi S, Fezzi M, and Bortul M
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- Angiography, Female, Humans, Indocyanine Green, Mastectomy, Necrosis, Nipples, Perfusion, Retrospective Studies, Breast Neoplasms diagnostic imaging, Breast Neoplasms surgery, Mammaplasty
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Methods: Consecutive women scheduled for nipple/skin-sparing/skin-reducing mastectomy between May 2020 and April 2021 were prospectively enrolled. Patients were divided into Group 1 in the absence of superficial and full-thickness necrosis (SN; FTN) and Group 2 in the presence of both. T1 (time between ICG injection and the initial perfusion of the least perfused MSF area), ICG-Q1, and ICG-Q% (absolute and relative perfusion values of the least vascularized area) were collected., Results: 38 breasts were considered. FTN was reported in 4 breasts (10.5%) and SN in 3 (7.9%). The two groups statistically differ in T1 (Group2 > Group1) and ICG-Q% (Group1 > Group2) ( p < 0.05). T1 could statistically predict ICG-Q1 and ICG-Q%. Both quantitative values have a sensitivity of 57% and a NPV of 89%; ICG-Q% shows higher specificity (81% vs 77%) and PPV (40% vs 36%)., Conclusions: Quantitative ICG angiography may additionally reduce MSF necrosis. Moreover, longer T1 may indicate possible postoperative necrosis. Considering these factors, intraoperative changes of reconstructive strategy could be adopted to reduce reconstructive failure., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Manuela Mastronardi et al.)
- Published
- 2022
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33. Spontaneous Bladder Rupture after Normal Vaginal Delivery: Description of a Rare Complication and Systematic Review of the Literature.
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Stabile G, Cracco F, De Santo D, Zinicola G, Romano F, De Manzini N, Scomersi S, and Ricci G
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Objective: To identify the possible causes of spontaneous bladder rupture after normal vaginal delivery and to propose a diagnostic and therapeutic algorithm., Material and Methods: MEDLINE (PubMed), Web of Science and Scopus databases were searched up to August 2020. Manuscripts considered were published from 1990 and only English articles were included. The research strategy adopted included the following terms: (bladder rupture) AND (spontaneous) AND (delivery). 103 studies were identified. Duplicates were found through an independent manual screening. Subsequently, two authors independently screened the full text of articles and excluded those not pertinent to the topic. Discrepancies were resolved by consensus. Finally, thirteen studies were included., Results: PRISMA guidelines were followed. For each study, fetal weight, catheterization during labor, parity, maternal age, occurrence time, previous abdominal or pelvic surgery, symptoms complained of, diagnostic methods, and treatment were considered. Median age was 26.0 (range 20-34 years); median presentation time was 3.0 days after delivery (range 1-20 days); and median newborn weight was 3227.0 g (range 2685-3600 g). Catheterization during labor was reported only in four of the thirteen cases (30.8%) identified. The symptoms most frequently complained of were abdominal pain and distension, fever, oliguria, haematuria and vomiting. Instrumental diagnosis was performed using X-rays in five cases and computerized tomography in six cases. Ultrasound was chosen in five cases as a first diagnostic tool. In two cases, cystography was performed. Treatment was always laparotomic repair of the visceral defect., Conclusion: Abdominal pain, increased creatinine and other signs of kidney failure on blood tests should lead to suspicion of this complication. Cystourethrography is regarded as a procedure of choice, but a first ultrasound approach is recommended. The main factor for the therapeutic choice is the intraperitoneal or extraperitoneal rupture of the bladder. Classical management for intraperitoneal rupture of the bladder is surgical repair and urinary rest.
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- 2021
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34. Comparison between male and female breast cancer survival using propensity score matching analysis.
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Scomersi S, Giudici F, Cacciatore G, Losurdo P, Fracon S, Cortinovis S, Ceccherini R, Zanconati F, Tonutti M, and Bortul M
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- Aged, Aged, 80 and over, Breast Neoplasms mortality, Breast Neoplasms pathology, Breast Neoplasms surgery, Breast Neoplasms, Male mortality, Breast Neoplasms, Male pathology, Breast Neoplasms, Male surgery, Female, Humans, Lymph Nodes surgery, Male, Middle Aged, Neoplasm Grading, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local surgery, Neoplasm Staging, Prognosis, Propensity Score, Retrospective Studies, Risk Assessment, Survival Analysis, Tumor Burden, Breast Neoplasms diagnosis, Breast Neoplasms, Male diagnosis, Lymph Nodes pathology, Neoplasm Recurrence, Local diagnosis
- Abstract
Male breast cancer (MBC) is a rare disease. The few studies on MBC reported conflicting data regarding survival outcomes compared to women. This study has two objectives: to describe the characteristics of a single-cohort of MBC and to compare overall survival (OS) and disease-free survival (DFS) between men and women using the propensity score matching (PSM) analysis. We considered MBC patients (n = 40) diagnosed between January 2004 and May 2019. Clinical, pathological, oncological and follow-up data were analyzed. Univariate analysis was performed to determine the prognostic factors on OS and DFS for MBC. We selected female patients with BC (n = 2678). To minimize the effect of the imbalance of the prognostic factors between the two cohorts, the PSM method (1:3 ratio) was applied and differences in survival between the two groups were assessed. The average age of MBC patients was 73 years. The 5-year OS and DFS rates were 76.7% and 72.2% respectively. The prognostic factors that significantly influenced OS and DFS were tumor size and lymph node status. After the PSM, 5 year-OS was similar between MBC and FBC (72.9% vs 72.3%, p = 0.70) while we found a worse DFS for MBC (72.2% vs 91.4%, p = 0.03). Our data confirmed previous reported MBC characteristics: we found a higher risk of recurrence in MBC compared to FMC but similar OS. MBC and FMC are different entities and studies are needed to understand its epidemiology and guide its management.
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- 2021
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35. Direct comparison of three different mathematical models in two independent datasets of EUSOMA certified centers to predict recurrence and survival in estrogen receptor-positive breast cancer: impact on clinical practice.
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Iacuzzo C, Giudici F, Scomersi S, Ceccherini R, Zanconati F, Generali D, and Bortul M
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- Female, Humans, Italy, Mastectomy, Models, Theoretical, Neoplasm Recurrence, Local epidemiology, Prognosis, Receptors, Estrogen genetics, Retrospective Studies, Breast Neoplasms epidemiology, Breast Neoplasms therapy
- Abstract
Purpose: Prediction algorithms estimating survival rates for breast cancer (BC) based upon risk factors and treatment could give a help to the clinicians during multidisciplinary meetings. The aim of this study was to evaluate accuracy and clinical utility of three different scores: the Clinical Treatment Score Post-5 Years (CTS5), the PREDICT Score, and the Nottingham Prognostic Index (NPI)., Methods: This is a retrospective cohort analysis conducted on prospectively recorded databases of two EUSOMA certified centers (Breast Unit of Trieste Academic Hospital and of Cremona Hospital, Italy). We included patients with Luminal BC undergone to breast surgery between 2010 and 2015, and subsequent endocrine therapy for 5 years for curative intent., Results: A total of 473 patients were enrolled in this study. ROC analysis showed fair accuracy for NPI, good accuracy for PREDICT, and optimal accuracy for CTS5 (AUC 0.7, 0.76, and 0.83, respectively). The three scores seemed strongly correlated in Spearman's rank correlation coefficient analysis. PREDICT partially overestimated OS in patients undergone to mastectomy, and in pT3-4, G3 tumors. Considering DRFS as a surrogate of OS, CTS5 showed women in intermediate and high risk class had shorter OS too (respectively p = 0.001 and p < 0.001). Combining scores does not improve prognostication power., Conclusion: Mathematical models may help clinicians in decision making (adjuvant therapies, CDK4/6i, genomic test's gray zones). CTS5 has the higher prognostic accuracy in predicting recurrence, while score predicting OS did not show substantial advances, proving that pN, G, and pT are still the most important variables in predicting OS.
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- 2021
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36. The current role of touch imprint cytology in sentinel lymph node intra-operatory examination.
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Iacuzzo C, Scomersi S, Giudici F, Bonadio L, Troian M, Bellio G, Rizzardi C, Bonazza D, Zanconati F, and Bortul M
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- Axilla, Female, Humans, Intraoperative Period, Lymph Nodes diagnostic imaging, Lymphatic Metastasis, Sensitivity and Specificity, Sentinel Lymph Node Biopsy, Touch, Breast Neoplasms, Sentinel Lymph Node diagnostic imaging
- Published
- 2020
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37. Association between benign thyroid disease and breast cancer: a single center experience.
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Dobrinja C, Scomersi S, Giudici F, Vallon G, Lanzaro A, Troian M, Bonazza D, Romano A, Zanconati F, de Manzini N, and Bortul M
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- Aged, Breast Neoplasms classification, Female, Follow-Up Studies, Humans, Male, Prognosis, Retrospective Studies, Thyroid Diseases classification, Thyroid Function Tests, Biomarkers analysis, Breast Neoplasms complications, Breast Neoplasms diagnosis, Thyroid Diseases complications, Thyroid Diseases diagnosis
- Abstract
Background: The relationship between breast cancer (BC) and thyroid disease (TD) is still controversial. The aim of the study was to investigate the possible coexistence of TD in patients with newly diagnosed BC and its correlation with BC clinical presentation with regard to menopausal status and stage of disease., Methods: This is a retrospective cohort study of all patients treated for primary BC between 2014 and 2016 at the Breast Unit of Trieste University Hospital. Clinical charts and reports were reviewed for coexisting thyroid disorders (i.e. hyperthyroidism, hypothyroidism, benign TD, thyroid cancer, thyroid autoimmunity) and menopausal status at the time of BC diagnosis. Biomolecular profile, stage, and grading of BC were also evaluated., Results: A total of 786 women and 7 men were included in the study. Co-presence of TD was found in 161(20.3%) cases: of these, 151(19.4%) patients presented benign TD and 10(1.3%) patients presented thyroid carcinoma. Thyroid autoimmunity was found in 51(32%) patients. Regarding thyroid function, 88(55%) patients had hypothyroidism, 19(12%) hyperthyroidism, and 54(33%) normal thyroid function. No statistically significant correlation was found between age and TD (p = 0.16), although TD was more common in women aged ≥60 years. Women with BC diagnosed at pre-menopausal age were more likely to have thyroid autoimmune diseases (45% vs. 29%, p = 0.05). No association was detected among BC molecular profiles with either thyroid autoimmunity (p = 0.26) or altered thyroid function (p = 0.63). High-grade BC was more frequent in women with hyperthyroidism (52.9%, p = 0.04), but the grading was independent from the presence of thyroid autoimmune disease (p = 0.87). BC stage was related to both thyroid autoimmunity (p = 0.04) and thyroid function (p < 0.001), with 55.2% of women affected by benign TD presenting with stage I BC and more aggressive BCs found in hypothyroid patients., Conclusions: According our study results, patients with primary BC present a greater incidence of autoimmunity disorders, especially when diagnosed in the pre-menopausal setting. However, further prospective studies are required to definitively prove causality.
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- 2019
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38. Modifiable and non-modifiable risk factors for surgical site infection after colorectal surgery: a single-center experience.
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Silvestri M, Dobrinja C, Scomersi S, Giudici F, Turoldo A, Princic E, Luzzati R, de Manzini N, and Bortul M
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- Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Diabetes Mellitus, Emergencies, Female, Humans, Incidence, Male, Middle Aged, Retrospective Studies, Surgical Wound Infection prevention & control, Colon surgery, Digestive System Surgical Procedures, Rectum surgery, Risk Factors, Surgical Wound Infection epidemiology, Surgical Wound Infection etiology
- Abstract
Purpose: Surgical site infection (SSI) is the most common complication of colorectal surgery, resulting in significant burden in terms of morbidity and length of hospital stay. The aims of this study were to establish the incidence of SSI in patients undergoing colorectal surgeries and to identify potentially modifiable risk factors to reduce overall SSI rates., Methods: This retrospective study analyzed patients who underwent colorectal resection at our Department. Patients were identified using a prospective SSI database. Univariate and multivariate analyses were used to identify risk factors., Results: A total of 687 patients were enrolled in the study and the overall SSI rate was 19.9% (137 patients). Superficial incisional surgical site infections (SSSIs) developed in 52 (7.6%) patients, deep incisional surgical site infections (DSSIs) developed in 15 (2.2%), and organ/space infections (OSIs) developed in 70 (10.1%). Univariate and multivariate analyses confirmed that age, diabetes, emergency surgery, and a high infection risk index are risk factors for SSI., Conclusions: There are some modifiable and non-modifiable risk factors for SSI. IRI and age are non-modifiable, whereas the timing of surgery and diabetes can be modulated by trying to defer some emergency procedures to elective ones and normalizing the glycemia of diabetic patients.
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- 2018
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39. Breastfeeding: a reproductive factor able to reduce the risk of luminal B breast cancer in premenopausal White women.
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Giudici F, Scaggiante B, Scomersi S, Bortul M, Tonutti M, and Zanconati F
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- Adult, Breast Neoplasms genetics, Case-Control Studies, Female, Humans, Italy epidemiology, Middle Aged, Risk Factors, Young Adult, Breast Feeding trends, Breast Neoplasms epidemiology, Breast Neoplasms prevention & control, Premenopause physiology, White People genetics
- Abstract
In the medical literature, the role of breastfeeding and reproductive factors in the risk of breast carcinoma is still an open debate in premenopausal women. We highlight the role of breastfeeding and reproductive factors in luminal A and luminal B, the most frequent breast cancers. This case-control study analyzes a White premenopausal population of 286 breast cancer patients, divided into molecular subtypes, and 578 controls matched by age. Multivariate logistic regression models were used to assess the relationships of breastfeeding and other reproductive factors (age at menarche, parity, age at first pregnancy, number of children) with the risk of breast cancers. Among the variables examined, reproductive factors did not alter the risk of cancer, whereas breastfeeding up to 12 months was a significant protective factor against luminal B breast cancer (multivariate odds ratio: 0.22, 95% confidence interval: 0.09-0.59, P=0.002). In contrast, luminal A cases did not significantly correlate with breastfeeding or other reproductive factors. Breastfeeding up to 12 months is strongly protective against the more aggressive luminal B, but not against the less aggressive luminal A breast cancer in premenopausal White women.
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- 2017
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40. Therapeutic strategy for ductal carcinoma in situ patients according to Van Nuys Prognostic Index.
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Andretta M, Scomersi S, Urbani M, and Bortul M
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- Adult, Breast Neoplasms pathology, Carcinoma, Intraductal, Noninfiltrating pathology, Female, Humans, Mastectomy, Segmental methods, Medical Records Systems, Computerized, Middle Aged, Neoplasm Grading, Neoplasm Staging, Prognosis, Retrospective Studies, Risk Factors, Treatment Outcome, Breast Neoplasms therapy, Carcinoma, Intraductal, Noninfiltrating therapy, Mastectomy methods, Radiotherapy, Adjuvant methods
- Abstract
Aim: Evaluation of therapeutic strategy for Ductal Carcinoma In Situ (DCIS) patients at our Brest Cancer Centre and analysis of our pattern of treatment with respect to Van Nuys Prognostic Index (VNPI) cathegories., Matherial of Study: Our study population is the result of a selection of 85 DCIS patients classified according to the VNPI risk of Local Recurrence (LR). A comparison was made between treatment effectively performed and therapy suggested by VNPI protocols., Results: Out of 53 DCIS women (62%) at low local recurrence risk, 5 patients underwent Breast Conserving Surgery (BCS) alone, 7 were treated with mastectomy and 41 underwent BCS followed by radiotherapy (RT). Out of 31 patients (37%) belonging to VNPI intermediate risk group, 25 cases recived BCS+RT and 6 cases received mastectomy. Only one patient (1%) belonged to VNPI high risk group and underwent mastectomy., Discussion: Only 31 patients (36,5%) had their definitive treatment according to recommended VNPI criteria, but none of the other 54 cases (63,5%) was undertreated. Performing mastectomy instead of BCS or adding adjuvant radiotherapy at BCS alone were not considered overtreatment because the therapeutic strategy was the result of a multidisciplinary discussion., Conclusion: As DCIS is a heterogeneus desease the one-size-fits-all approach to treatment seems inappropriate. The VNPI was developed in order to help treatment choices, but therapeutic strategies can't be based only on local recurrence risk and need a multidisciplinary approach., Key Words: Breast cancer, Ductal carcinoma in situ, Van Nuys Prognostic Index.
- Published
- 2014
41. Occult breast cancer during reduction mammoplasty: case report.
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Panizzo N, D'Aloja C, Scomersi S, Papa G, Bortul M, and Arnez ZM
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- Aged, Female, Humans, Incidental Findings, Breast Neoplasms diagnosis, Carcinoma, Ductal, Breast diagnosis, Mammaplasty
- Abstract
Aim: Breast carcinoma occurring in routine reduction mammaplasty is rare., Material of Study: In our Breast Unit each patient eligible for any breast surgery is routinely evaluated by preoperative breast imaging. We reported the clinical case of a woman with an infiltrating lobular breast cancer detected during surgical reduction mammaplasty despite a negative preoperative bilateral mammography., Results: The clinical case was discussed at multidisciplinary breast cancer meeting in order to evaluate the different therapeutic options. In conjunction with general surgeons, oncologists, radiologists and radiotherapists, and upon patient's ultimate decision, a conservative tumor approach was chosen: first-level axillary node dissection followed by adjuvant chemotherapy and hormonotherapy., Discussion: The mean frequency of breast cancer detection during reduction mammaplasty ranges from 0.06% up to 4%. There are many possible treatment choices for these patients ranging from radical mastectomy to more conservative approaches dealing with lumpectomy followed by radiation therapy or chemotherapy and radiation therapy alone. The therapeutical plan must be discussed by a multidisciplinary team and many tumors and patients characteristics should be evaluated in the decision making process., Conclusion: All patients selected for breast aesthetical surgery must be screened, during preoperative workup, for breast cancer. Combination of three diagnostic modalities increases sensitivity and reaches the diagnostic accuracy of 93.2%. The reported case stresses the importance of an oncological approach to breast surgery even in case of planned aesthetical procedures.
- Published
- 2013
42. Single-incision transumbilical laparo-endoscopic gastric benign tumor resection.
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Dapri G, Ntounda R, Himpens J, Carnevali P, Scomersi S, and Cadière GB
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- Adult, Humans, Male, Gastrectomy, Gastroscopy, Laparoscopy, Stomach Neoplasms pathology, Stomach Neoplasms surgery
- Abstract
Introduction: The authors report resection of a gastric benign tumor through single-incision laparoscopy, guided by peroperative gastroscopy. VIDEO: A 25-year-old man consulted after diagnosis of a 40 × 20 cm(2) endoluminal lesion of the gastric cardia. Preoperative work-up showed a stromal tumor with invasion of the muscular layer. The umbilical scar was incised and, after placement of a purse-string suture, an 11-mm nondisposable trocar was inserted for a 10-mm 30° angled scope. Curved and reusable instruments (Karl Storz-Endoskope, Tuttlingen, Germany) and straight ultrasonic shears (Ethicon Endosurgery, Cincinnati, OH, US) were inserted transumbilically. Peroperative gastroscopy located the lesion on the smaller gastric curvature, 1 cm from the gastroesophageal junction. A stitch was placed in the center of the lesion, and gastroscopic grasper helped in maintaining the limits of resection. Gastrostomy was closed using two converting absorbable running sutures. Because of the curves of the instruments there was no conflict between the instruments' tips inside the abdomen (Fig. 1a), or between the surgeon's hands outside the abdomen (Fig. 1b). Leak test with the gastroscope checked the integrity of the suture. The specimen was retrieved transumbilically in a plastic bag., Results: Operative time was 150 min, and the umbilical incision was less than 15 mm. The patient was discharged after 5 days, and he is doing well 3 months postoperatively., Conclusions: Laparoscopic gastric resection can be safely performed through a single-access. Peroperative gastroscopy permits the limits of resection to be precisely determine, and use of curved and reusable instruments allows surgeon to achieve ergonomic conditions as in classic laparoscopy, without increasing the laparoscopic cost.
- Published
- 2011
- Full Text
- View/download PDF
43. Clinicopathologic factors predicting involvement of nonsentinel axillary lymphnodes in breast cancer patients: is axillary dissection always indicated?
- Author
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Scomersi S, Da Pozzo F, Torelli L, Zanconati F, Tonutti M, Dore F, and Bortul M
- Subjects
- Adult, Aged, Aged, 80 and over, Axilla, Female, Humans, Lymphatic Metastasis, Middle Aged, Prognosis, Retrospective Studies, Breast Neoplasms pathology, Breast Neoplasms surgery, Lymph Node Excision
- Abstract
Aim: The aim of this study was to determine factors that predict non-sentinel axillary lymph nodes (NSLNs) metastases in breast cancer patients with positive sentinel node biopsy (SLNB)., Material of Study: We reviewed the records of a consecutive series of 176 breast cancer patients who underwent SLNB at our institution. From the database we analysed those cases with one or more positive sentinel lymph nodes (SLNs) in order to determine factors predicting NSLN metastases., Results: From a series of 176 consecutive patients, we evaluated 41 cases (23.3%) with positive SLNB. Subsequent completion axillary lymph node dissection (CALND) revealed NSLN metastases in 15 cases (36.6%). The significant variables predictive of NSLN involvement were the presence of macrometastases with extranodal extension (p = 0.048), the presence of more than one positive SLN (p = 0.08) and a ratio between positive SLN and SLNs globally dissected higher than 0.5 (p = 0.05)., Discussion: CALND is the gold standard for patients with positive SLNB, but results, in almost 40-70% of cases, in no additional positive nodes and its therapeutic benefit remains controversial. Clinicopathologic factors predictive of NSLN metastases may be useful in identifying a subset of patients with lower risk of further axillary involvement., Conclusions: In patients with early breast carcinoma and a positive SLNB, the size of SLN metastases, the presence of extranodal extension, more than one positive SLN and a nodal ratio higher than 0.5 are the factors that significantly increase the frequency of additional axillary positive lymph nodes.
- Published
- 2010
44. [Neuroendocrine carcinoma of the breast: a rare entity].
- Author
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Sartori A, Scomersi S, Spivach A, and Vigna S
- Subjects
- Aged, Breast Neoplasms diagnosis, Breast Neoplasms therapy, Carcinoma, Neuroendocrine diagnosis, Carcinoma, Neuroendocrine therapy, Chemotherapy, Adjuvant, Female, Humans, Mastectomy, Segmental methods, Radiography, Radiotherapy, Adjuvant, Sentinel Lymph Node Biopsy, Treatment Outcome, Breast Neoplasms diagnostic imaging, Breast Neoplasms pathology, Carcinoma, Neuroendocrine diagnostic imaging, Carcinoma, Neuroendocrine pathology
- Abstract
Nowadays neuroendocrine breast cancer is a rare entity, though the presence of neuroendocrine cells is often detected within breast cancers. Most of these tumours are associated with conventional ductal or globular breast cancers. We describe the case of neuroendocrine cancer of the breast and discuss its clinical, radiological and cytological aspects.
- Published
- 2009
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