1
|
Lescarbotte F, Romano G, Balleyguier C, Arfi Rouche J, Ilenko A, Leymarie N. [Extensive transfixing skin necrosis after breast biopsy under local anesthesia: About four cases]. ANN CHIR PLAST ESTH 2024; 69:27-33. [PMID: 37121845 DOI: 10.1016/j.anplas.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Local anesthetics with adrenaline are widely used in routine practice and have long proven their benefits and safety. The rare complications due to their use mainly concern immuno-allergic and vascular mechanisms. DESCRIPTION In this article, we present four similar cases of early transfixing skin necrosis occurring after radioguided breast biopsy under local anesthesia using epinephrine local anesthetics in the context of a diagnostic approach to breast cancer. DISCUSSION Although the literature is comforting about the use of local anesthetics, even on the extremities, severe skin complications continue to be reported sporadically. The analysis and understanding of these phenomena would allow, in the long run, to avoid them and to reduce their importance. CONCLUSION The occurrence of skin necrosis after breast biopsy under radiographic control is rare and seems to be related to the local anesthetic procedure. Although similar cases have been reported in the literature, it does not seem possible today to conclude on the exact physiopathology of these complications. A better knowledge of the pathophysiology of these complications would help to avoid their occurrence in the future.
Collapse
Affiliation(s)
- Francois Lescarbotte
- Department of Plastic and Breast Surgery, Gustave-Roussy Cancer Campus, Grand Paris, France.
| | - Golda Romano
- Department of Plastic and Breast Surgery, Gustave-Roussy Cancer Campus, Grand Paris, France
| | - Corinne Balleyguier
- Department of Medical Imagery, Gustave-Roussy Cancer Campus, Grand Paris, France
| | - Julia Arfi Rouche
- Department of Medical Imagery, Gustave-Roussy Cancer Campus, Grand Paris, France
| | - Anna Ilenko
- Department of Plastic and Breast Surgery, Gustave-Roussy Cancer Campus, Grand Paris, France
| | - Nicolas Leymarie
- Department of Plastic and Breast Surgery, Gustave-Roussy Cancer Campus, Grand Paris, France
| |
Collapse
|
2
|
Flory V, Lévy G, Viotti J, Schiappa R, Elkind L, Ghez C, Pellegrin A, Occelli A, Dejode M, Delpech Y, Fouché Y, Figl A, Machiavello JC, Haudebourg J, Peyrottes I, Chapellier C, Barranger E. [Preoperative breast imaging review: Interests and limits of specialized validation in oncology]. Bull Cancer 2020; 107:295-307. [PMID: 32115178 DOI: 10.1016/j.bulcan.2019.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/06/2019] [Accepted: 11/16/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To evaluate the impact of systematic radiological review by breast specialist radiologist of malignant breast lesion imaging on the therapeutic management of patients. MATERIALS AND METHODS Data collection was performed for patients with histopathologically proved breast cancer or suspicious breast lesion on imaging realized out of our institution. Patients underwent systematic mammary and axillary ultrasound, imaging review and if necessary complementary mammographic images. We analyzed the number of additional breast biopsies and axillary lymph node fine needle aspiration (FNA) with their histopathological results. We assessed their impact by comparing the final surgical treatment to the one planned before review. RESULTS Two hundred and seventeen patients were included, with a total of 230 BIRADS 0, 4, 5 or 6 breast lesions. Seventy-six additional breast core biopsies were realized, leading to diagnose 43 additional BIRADS 6 lesions (24 infiltrative carcinomas, 9 DCIS and 10 atypical lesions) in 30 patients (13.82%). Thirty-five additional lymph node FNA were realized with 12 metastatic nodes and 3 false negative samples. Imaging review lead to change surgical treatment in 59 patients (27.19%, P<0.01) with modification in breast surgery in 37 patients, axillary surgery in 8 patients and both sites surgery in 12 patients. CONCLUSION This study shows an impact of systematic radiological review by breast specialist radiologist in therapeutic management of patients treated for malignant breast lesion.
Collapse
Affiliation(s)
- Violaine Flory
- Centre Antoine-Lacassagne, service d'imagerie médicale, 33, avenue Valombrose, 06189 Nice, France.
| | - Gwendoline Lévy
- Centre Antoine-Lacassagne, service d'imagerie médicale, 33, avenue Valombrose, 06189 Nice, France
| | - Julien Viotti
- Centre Antoine-Lacassagne, département d'épidémiologie, de biostatistiques et des données de santé, 33, avenue Valombrose, 06189 Nice, France
| | - Renaud Schiappa
- Centre Antoine-Lacassagne, département d'épidémiologie, de biostatistiques et des données de santé, 33, avenue Valombrose, 06189 Nice, France
| | - Laura Elkind
- Centre Antoine-Lacassagne, service d'imagerie médicale, 33, avenue Valombrose, 06189 Nice, France
| | - Céline Ghez
- Centre Antoine-Lacassagne, service d'imagerie médicale, 33, avenue Valombrose, 06189 Nice, France
| | - Amélie Pellegrin
- Centre Antoine-Lacassagne, service d'imagerie médicale, 33, avenue Valombrose, 06189 Nice, France
| | - Aurélie Occelli
- Centre Antoine-Lacassagne, service d'imagerie médicale, 33, avenue Valombrose, 06189 Nice, France
| | - Magali Dejode
- Centre Antoine-Lacassagne, service de chirurgie oncologique gynécologique et sénologique, 33, avenue Valombrose, 06189 Nice, France
| | - Yann Delpech
- Centre Antoine-Lacassagne, service de chirurgie oncologique gynécologique et sénologique, 33, avenue Valombrose, 06189 Nice, France
| | - Yves Fouché
- Centre Antoine-Lacassagne, service de chirurgie oncologique gynécologique et sénologique, 33, avenue Valombrose, 06189 Nice, France
| | - Andrea Figl
- Centre Antoine-Lacassagne, service de chirurgie oncologique gynécologique et sénologique, 33, avenue Valombrose, 06189 Nice, France
| | - Jean-Christophe Machiavello
- Centre Antoine-Lacassagne, service de chirurgie oncologique gynécologique et sénologique, 33, avenue Valombrose, 06189 Nice, France
| | - Juliette Haudebourg
- Laboratoire d'anatomocytopathologie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France
| | - Isabelle Peyrottes
- Laboratoire d'anatomocytopathologie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France
| | - Claire Chapellier
- Centre Antoine-Lacassagne, service d'imagerie médicale, 33, avenue Valombrose, 06189 Nice, France
| | - Emmanuel Barranger
- Centre Antoine-Lacassagne, service de chirurgie oncologique gynécologique et sénologique, 33, avenue Valombrose, 06189 Nice, France
| |
Collapse
|