Our 20-Year Institutional Experience with Surgical Approach for Breast Hamartomas

Objective

Hamartomas are rare, slowly-growing breast tumours. Clinical, radiological and histopathological examination together increase the diagnostic accuracy. To evaluate the clinicopathologic features of hamartomas and outline our clinical approach to hamartomas in our 20-year experience at our Breast Clinic.

Materials and Methods

Between 1995 and 2015, 24 cases were retrospectively analyzed with a diagnosis of breast hamartoma at our Breast Clinic followed by excisional biopsy. Data was obtained on patient demographics, clinical examination, radiological findings and histopathological subtypes.

Results

Of 1338 benign breast tumours excised from January 1995 to January 2015, 24 (1.8%) were identified as breast hamartoma. Median age of patients was 42 (range, 13-70), whereas the median tumour size was 5 cm (1-10 cm). On preoperative imaging, hamartoma was most commonly misdiagnosed as fibroadenoma. Pathological examination of the 24 biopsy specimens revealed 3 cases with pseudoangiomatous stromal hyperplasia, and another hamartoma associated with a radial scar within the centre of the lesion. Of those, one patient was diagnosed with malignant phylloides tumour in the same breast. At a median follow-up 58.4 months, none of the patients recurred or developed malignancy.

Conclusion

Hamartomas can often be missed by clinicians, due to its benign nature which is poorly understood. Despite their slow growth, hamartomas can reach large sizes and can cause breast asymmetry. Although it is rare, hamartoma can be seen along with malignancy, as it is formed from similar components of breast tissue. Therefore, careful diagnosis and appropriate management including surgery are required.

Evaluation of the effectiveness of home based or hospital based calisthenic exercises in patients with multiple sclerosis

OBJECTIVES

The aim of this study is to evaluate the effects of calisthenic exercises on balance, walking speed, fatigue, quality of life, and psychological status in patients with Multiple Sclerosis (MS).

PATIENTS AND METHODS

Forty patients diagnosed with MS were randomized into two exercise groups (group 1 = hospital-based, group 2 = home-based). Outcome measures including the MS International Quality of Life Scale, 10-meter walking test, Berg Balance Scale, Fatigue Severity Scale and the Hospital Anxiety Depression Inventory were assessed at the baseline and at 12-weeks.

RESULTS

Thirty-six participants completed the exercise programme (hospital based = 16, home based = 20). The mean age was 32.83 ± 3.64 years. The mean duration of disease was 6.97 ± 3.15 years. Hospital-based and home-based exercise groups had significant improvements in the balance, 10-meter walking test, anxiety, and the quality of life after the 12-week exercise programme. There was a significant improvement in the hospital-based patients in terms of the depression scores. No significant improvement was observed in terms of fatigue in any of the groups. When both groups were compared, the improvement in the balance and depression scores of the hospital-based patients was significantly higher than the home-based patients.

CONCLUSIONS

Calisthenic exercises can be easily performed both at home and in hospital setting. In patients with MS, calisthenic exercises performed at home or at the hospital may improve the balance, quality of life, and the functional and psychological status, while no significant effect has been observed on fatigue.