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Renzulli M, Zanotti S, Clemente A, Mineo G, Tovoli F, Reginelli A, Barile A, Cappabianca S, Taffurelli M, Golfieri R. Hereditary breast cancer: screening and risk reducing surgery. Gland Surg 2019; 8:S142-S149. [PMID: 31559181 PMCID: PMC6755941 DOI: 10.21037/gs.2019.04.04] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The screening modalities for women at high risk for breast cancer has received an increasing role during the last years. The aim of this study was to evaluate the performance of our screening program comparing the diagnostic sensitivity of clinical breast examination, mammography, ultrasonography (US) and magnetic resonance imaging (MRI). METHODS Clinical Breast examination, mammography, US and MRI for each patient with BRCA1 and BRCA2 mutation who underwent breast surgery in our Institution from October 2008 to April 2016 were retrospectively evaluated. The diagnostic accuracy for MRI and for the other surveillance tests in identifying early breast cancer were assessed. RESULTS Twenty-six female patients with genetic mutation underwent breast surgery. Twenty-two out of 26 (85%) developed cancer during the dedicated screening protocol whereas 4 women who underwent surgery did not have cancer. Imaging was able to detect cancer in all 22 patients (per patient sensibility of 100%), identifying all 35 neoplastic lesions (per lesion sensibility of 100%). The combination of Clinical Breast Examination, US and mammography aided the cancer diagnosis in 14 (64%) of patients with a sensitivity of 64% and specificity of 100%. MRI identified all the cancers, with sensibility and specificity of 100%. Moreover, in 8 (36%) of the 22 patients who developed breast cancers, the cancers were detected only by MRI, revealing a significant superiority respect to the other surveillance modalities (P<0.05). CONCLUSIONS MRI demonstrated to be the best imaging modality in detection of breast cancer even for lesion <1 cm. Prophylactic mastectomy is the most effective risk reduction strategy in women at high risk, contributing to the reduction of anxiety related to the condition of a carrier.
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Affiliation(s)
- Matteo Renzulli
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Simone Zanotti
- Breast Unit, Department of Woman, Child and Urological Diseases, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Alfredo Clemente
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Giangaspare Mineo
- Radiology Unit, Department of Diagnostic Medicine and Prevention, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Francesco Tovoli
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alfonso Reginelli
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, S. Salvatore Hospital, L’Aquila, Italy
| | - Salvatore Cappabianca
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Mario Taffurelli
- Breast Unit, Department of Woman, Child and Urological Diseases, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
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Okamoto M, Kito M, Yoshimura Y, Aoki K, Suzuki S, Tanaka A, Takazawa A, Yoshida K, Kato H. The status quo of treatment and clinical outcomes for patients over 80 years of age with high-grade soft tissue sarcoma: report from the soft tissue tumor registry in Japan. Jpn J Clin Oncol 2018; 48:900-905. [DOI: 10.1093/jjco/hyy118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/31/2018] [Indexed: 12/21/2022] Open
Affiliation(s)
- Masanori Okamoto
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Munehisa Kito
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Yasuo Yoshimura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Kaoru Aoki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Shuichiro Suzuki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Atsushi Tanaka
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Akira Takazawa
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Kazushige Yoshida
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Hiroyuki Kato
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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Reginelli A, Silvestro G, Fontanella G, Sangiovanni A, Conte M, Nuzzo I, Di lecce A, Martino A, Grassi R, Murino P, Cappabianca S. Performance status versus anatomical recovery in metastatic disease: The role of palliative radiation treatment. Int J Surg 2016; 33 Suppl 1:S126-31. [DOI: 10.1016/j.ijsu.2016.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Santangelo G, Pellino G, De Falco N, Colella G, D'Amato S, Maglione MG, De Luca R, Canonico S, De Falco M. Prevalence, diagnosis and management of ectopic thyroid glands. Int J Surg 2015; 28 Suppl 1:S1-6. [PMID: 26708843 DOI: 10.1016/j.ijsu.2015.12.043] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 04/25/2015] [Accepted: 05/10/2015] [Indexed: 12/13/2022]
Abstract
Ectopic thyroid tissue (ETT) is an uncommon entity that may be found anywhere along the line of the obliterated thyroglossal duct, usually from the tongue to the diaphragm. We performed a retrospective analysis of patients undergoing surgical treatment for thyroid disease between January 2000 and December 2013, seeking for ETT All patients with prior neck surgery or trauma were excluded. The clinic-pathologic features, prevalence and diagnosis of the lesions were collected and analyzed. Out of 3092 included patients, 28 ETT were identified (0.9%). The anatomical site of ETT was as follows: lateral cervical in 6 (21.4%), along the thyroglossal duct in 6 (21.4%), mediastinal in 5 (17.9%), lingual in 5 (17.9%), sublingual in 3 (10.7%), and submandibular in 3 (10.7%). Histopathology revealed 27 benign lesions and 1 (3.6%) papillary carcinoma. ETT is found in less than 1% of patients receiving thyroid surgery. Diagnosis of ETT requires clinical imaging. Surgery is a prudent choice due to the potential of malignant evolution of ETT.
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Affiliation(s)
- Giuseppe Santangelo
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Gianluca Pellino
- Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Nadia De Falco
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Giuseppe Colella
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Salvatore D'Amato
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - M Grazia Maglione
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Roberto De Luca
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Silvestro Canonico
- Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Massimo De Falco
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
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