Breast cancer is a socially relevant group of malignant conditions of the mammary gland, affecting both males and females. Most commonly the surgical approach of choice is a modified radical mastectomy (MRM), due to it allowing for both the removal of the main tumor mass and adjacent glandular tissue, which are suspected of infiltration and multifocality of the process, and a sentinel axillary lymph node removal. Most common post-surgical complications following MRM are the formation of a hematoma, the infection of the surgical wound and the formation of a seroma. These post-surgical complications can, at least in part, be attributed to the drainage of the surgical wound. However, the lack of modern and official guidelines provides an ample scope for innovation, but also leads to a need for a randomized comparison of the results. We compared different approaches to wound drainage after MRM, reviewed based on the armamentarium, number of drains, location, type of drainage system, timing of drain removal and no drainage alternatives. Currently, based on the general results, scientific and comparative discussions, seemingly the most affordable methodology with the best patient outcome, with regards to hospital stay and post-operative complications, is the placement of one medial to lateral (pectoro-axillary) drain with low negative pressure. Ideally, the drain should be removed on the second or third postoperative day or when the amount of drained fluid in the last 24 hours reaches below 50 milliliters.

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1415I N A 60-YEAR-OLD male with a 14-year history of viral hepatitis and liver cirrhosis, an ultrasound examination of the thyroid gland (2002) revealed a 10/8 cm hypoechoic lesion in the left thyroid lobe with partially retrosternal location, unclear outlines and microcalcifications. Fine-needle aspiration biopsy (FNAB) cytology result was follicular adenoma but follicular type of papillary thyroid carcinoma could not be ruled out. The patient was admitted for surgery in our institution in October 2002. Intraoperative examination revealed left thyroid lobe, 12/10 cm in size, with hard consistency; the strap muscles as well as the lymph nodes in the central cervical compartment of the neck and the inferior thyroid artery were also invaded. There were no macroscopic changes in the right thyroid lobe. Thyroidectomy with selective cervical node dissection was performed. On macroscopic examination of the specimen, some green-yellowish areas (1) with extratumoral location (2) were found (Fig. 1). Hystologic result was follicular type of papillary thyroid carcinoma in the left thyroid lobe (1), metastases from hepatocellular carcinoma in the same lobe (2) (Fig. 2A); tumor emboli from papillary (1) and hepatocellular (2) carcinoma in the vessels (Fig. 2B); adenoma of the left inferior parathyroid gland (Fig. 3); focci of papillary thyroid carcinoma and focci of hepatocellular carcinoma in the ipsilateral lymph nodes from the central cervical compartment (Fig. 4).

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