Postoperative wound complications were not different from those observed in non-radiated patients, but its rate was higher. Epidermolysis was associated with SSI and/or flap necrosis. Careful surgical technique should be encouraged.
Objective: To identify clinical, radiological, and histopathological characteristics that could be predictive factors of microinvasive/ invasive breast carcinoma in patients with diagnosis of ductal carcinoma in situ (DCIS) by core-needle biopsy. Material and methods: This is a retrospective study conducted from 2006-2017, which included women ≥18 years of age with initial DCIS, and who were treated with surgery. Final diagnosis was divided in DCIS and microinvasive/invasive carcinoma. Results: 334 patients were included: 193 (57.8%) with DCIS and 141 (42.2%) with microinvasive/invasive carcinoma (microinvasive 5.1%, invasive 37.1%). Lymph node metastasis occurred in 16.3%. Differences between DCIS and microinvasive/invasive groups included the presence of palpable nodule (36.7% vs. 63.2%), radiological nodule (29% vs. 51%), bigger radiological-tumor size (1.2 cm vs. 1.7 cm), and larger microcalcification extension (2.5 cm vs. 3.1 cm), all of these variables p ≤0.05. Hormonal receptors and HER2 expression were similar. After logistic regression analysis, predictive factor of invasion was the presence of palpable nodule (OR = 4.072, p <0.001) and radiological multicentric disease (OR = 1.677, 95%CI = 1.036-2.716, p = 0.035). Conclusions: In patients with DCIS, palpable nodule, and radiological multicentric disease, upgrade to microinvasive/invasive is high, and sentinel lymph node is recommended.
Multicenter studies on breast cancer require inter-institutional collaboration, resources and specialized personnel. In Mexico, many institutions provide these services, but their information is not accessible; to mitigate it, the Mexican Society of Oncology formed the Mexican Cooperative Research Groups in Oncology. Objective: To describe the infrastructure, personnel and activities of hospitals with care of patients with breast cancer in Mexico. Methods: A survey was conducted to 30 breast cancer specialists about resources and services of their institutions. Results: 13 (43.3%) specialists answered the survey, 38.5% of Seguro Popular, 23.1% of Instituto Mexicano del Seguro Social, and 38.4% of other institutions, with a median of 300 (50-950) new cases per year. All the institutions have oncological surgery, breast radiology, palliative care, pathology, nutrition and multidisciplinary sessions. All have ultrasound with breast transducer, 92.3% digital mammography, and 53.8% tomosynthesis and/or magnetic resonance. They do sentinel lymph node detection with dye (92.3%) or radionuclide (61.5%). Tamoxifen, aromatase inhibitors and trastuzumab are available in 92.3%, and other target therapies in < 40%. Genetic signatures are done in 21.3% and 61.5% analysis of hereditary cancer. Conclusions: The institutional capacity to participate in multicenter studies is heterogeneous; the few resources in several institutions limit their inclusion to studies of breast cancer.
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