Rare chondrosarcoma of the breast treated with quadrantectomy instead of mastectomy: A case report

Pasta, Vittorio; Sottile, Daniela; Urciuoli, Paolo; Vecchio, Luca Del; Custureri, F; D’Orazi, Valerio

doi:10.3892/ol.2014.2803

Cited by 16 publications

(13 citation statements)

References 22 publications

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“…The choice of a more or less demolitive surgical intervention (respectively, mastectomy and quadrantectomy) is based on the possibility to obtain adequate margins of healthy peritumoral tissue which would ensure both the complete removal of the tumor and the excision of possible skip metastases, that unlike what happens in other tumors, including melanoma, are not detectable by instrumental examinations [ 22 – 26 ]. To reach this goal, it is particularly important to evaluate the tumor/breast size ratio before surgery in order to properly perform a correct planning of the surgical strategy which could include even conservative surgery without compromising the prognosis [ 27 ]. Thus, we showed here that, despite the large size of the tumor compared to the breast (Fig.…”

Section: Discussionmentioning

confidence: 99%

Primitive sarcoma of the breast: new insight on the proper surgical management

Pasta

Monti

Cialini³

et al. 2015

J Exp Clin Cancer Res

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BackgroundPrimitive sarcoma of the breast is a rare and challenging disease at high risk of recurrence and with poor prognosis. There are controversies in the diagnosis and management of such solid tumor due to its rarity and heterogeneity. This sarcoma is poorly responsive to both chemotherapy and radiotherapy, thus, surgery is the first and most important therapeutic approach. However, given the rarity of this type tumor it has not be possible to standardize unique guidelines for the proper surgical strategy to adopt. Here, we performed a retrospective study of new 10 cases of primitive sarcoma of the breast that underwent either mastectomy or a more conservative quadrantectomy, in the attempt to better standardize correct surgical indications.MethodsTen new cases of primitive sarcoma of the breast were registered between 2002 and 2012 and constituted the study group. They underwent either mastectomy or quadrantectomy and the clinical, prognostic and survival characteristics after surgery were analysed.ResultsWithin the group of patients treated with mastectomy, two had metastasis and died because of that. Among the five patients treated with quadrantectomy four are alive and free of disease after 3 to 5 years follow-up, while the patient with sarcoma arising in pregnancy, although is still alive, developed lung metastases four years after surgery.ConclusionsThe first and most important therapeutic approach to primary sarcomas of the breast is surgical which has the purpose to achieve radical tumor excision to prevent local recurrence and skip metastases. However, given the rarity of the condition and the consequent small number of cases in this, like in similar studies, it is not possible to draw any definitive conclusions and further studies with larger numbers are necessary. However it would appear that performing a larger procedure such as mastectomy rather than performing a more limited one such as a quadrantectomy, has no advantage in terms of overall prognosis.

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Section: Discussionmentioning

confidence: 99%

Primitive sarcoma of the breast: new insight on the proper surgical management

Pasta

Monti

Cialini³

et al. 2015

J Exp Clin Cancer Res

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“…Estudos sobre neoplasias mamárias em cadelas são frequentes (Itoh et al, 2005;Sleeckx et al, 2011;Caldas et al, 2016) e a extirpação do tumor com margem cirúrgica ainda é a melhor maneira de alcançar a cura (Sleeckx et al, 2011;Sorenmo et al, 2013), porém faltam dados que comparem as técnicas cirúrgicas mais radicais com as conservadoras, as quais inclui a quadrantectomia. Em mulheres esta técnica é bem consolidada e resulta na cura de pacientes mesmo com tumores malignos (Pasta et al, 2015).…”

Section: Discussionunclassified

Vantagens da técnica de quadrantectomia em cadelas com neoplasias mamárias

Caldas¹,

Oliveira²,

Oliveira³

et al. 2017

Braz. J. Vet. Med.

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Copyright Caldas et al. Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution Non-Commercial, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que sem fins comerciais e que o trabalho original seja corretamente citado. A pré-anestesia foi realizada com Acepromazina 0,2% (0,2 mg/kg, IM) ou Diazepan 0,5% (0,5 mg/kg, IM). A indução anestésica geral foi feita com Diisopropilfenol 1% (2,0 a 8,0 mg/kg, IV) e a manutenção anestésica geral com Isoflurano ofertado por traqueotubo e diluído em oxigênio a 100%, em circuito fechado de anestesia. O emprego da técnica de quadrantectomia para exérese de neoplasias mamárias constituiu uma manobra preventiva ao surgimento de novas massas tumorais, comprovada mediante a taxa de sobrevivência de 95,5%, em comparação com o emprego da técnica de mastectomia unilateral direita ou esquerda ou ainda a mastectomia bilateral total, cuja taxa de sobrevivência foi de 90,5%. A técnica é facilmente executável, associada ao método de dissecção, uso de dreno cirúrgico e curativo compressivo. Vantagens da técnica de quadrantectomia em cadelas com neoplasias mamárias Advantages of quadrantectomy in bitches with mammary neoplasmPalavras-chave: cães, mastectomia, tumores, quadrantectomia. AbstractA great number of surgical procedures have been proposed for the treatment of mammary tumors in bitches; however, few surveys have compared the accuracy of different techniques in dogs. Our study aimed to establish a quadrantectomy clinical and surgical protocol for the treatment of mammary tumors in bitches, similar to those performed in women. Between March 2014 and December 2015, 154 bitches were admitted to the Obstetric Sector of the Veterinarian Hospital of the Rural Federal University of Rio de Janeiro. One hundred and forty-one of those bitches presented different variants of mammary tumors and were treated with surgical procedures. Pre-operational evaluation included tumor staging through the TNM system and assessment of surgical risk. The following agents were used throughout the surgical procedures: Acepromazine 0.2% (0.2 mg/kg, IM) or Diazepam for pre-anesthesia, a Diisopropylphenol 0.5% (2.0 to 8.0 mg/kg, IV), IM during the general anesthesia induction, and closed-circuit Isoflurane in the stage of management of anesthesia. Quadrantectomy was performed as a maneuver to prevent tumor recurrence. The maneuver proved effective due to the 95.5% survival rate, compared to the 90.5% survival rate of right or left unilateral mastectomy and bilateral mastectomy techniques. Quadrantectomy in association with dissection method, surgical drain, and compression bandaging was considered an effective and easily applicable surgical procedure in bitches with mammary tumors.

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“…Based on our more than thirty years' experience in other fields of general microsurgery (limb replantation, microvascular free flap, vasectomy reversal and seminal tract reconstruction, inferior laryngeal nerve reconstruction, etc.) (8,(20)(21)(22)(23)(24)(25)(26)(27), we believe that the use of the operating microscope during thyroid surgery might be replaced by 4.5x loupes which allows a larger operating field with consequent benefits in surgical procedures and patients outcome. Moreover, the use of the operating microscope also allows recording which has obvious benefits for both teaching purposes and for a medico-legal standpoint (4).…”

Section: Discussionmentioning

confidence: 99%

“…Our experience in many areas of general surgery and reconstructive microsurgery (8,(20)(21)(22)(23)(24)(25)(26)(27), has prompted us to consider the benefits related to the application of microsurgical technique and the use of loupes in neck surgery. Therefore, the aim of the present retrospective study was to review ten years of thyroid surgery performed with use of loupes magnification and microsurgical technique by our team in a single institution and analyze the outcomes with respect to those reported in the literature with other surgical techniques.…”

Section: Introductionmentioning

confidence: 99%

Use of loupes magnification and microsurgical technique in thyroid surgery: ten years experience in a single center

D’Orazi¹,

Panunzi²,

E³

et al. 2016

GCHIR

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Thyroid surgery has been characterized in the last years by significant innovations which are well codified and standardized. Although the mortality rate is remarkably reduced (0.065%) compared to the early 1900s (1), thyroid surgery is still not free from risk of complications such as those related to the injury of laryngeal nerves and parathyroid glands (2, 3). The two most common early complications of thyroid surgery are hypocalcemia (20-30%) and recurrent laryngeal nerve injury (5-11%) (2). Bilateral recurrent nerve paralysis resulting in adduction of the vocal cords is a rare life-threatening complication occurring in less than 0.1% of cases that requires emergency management (2). To prevent or reduce the incidence of these events it is of primary importance an excellent anatomical knowledge of the neck as well as the application of a meticulous surgical technique (4-6). Thus, the rate of these complications is directly related to the extent of thyroidectomy and to a radical thyroid excision (without macroscopic thyroid residual) as well as to the surgeon's experience (7).Microsurgical technique with the use of microscope is usually performed to make microvascular anastomosis of limb replantation and free flap in many surgical specialities (8-10). Starting from 1975, and to the best of our knowledge, only few works have been published about the use of microsurgical technique and magnification as a support to traditional thyroid surgery; interestingly, though, the results show that such treatment approach helps surgical performance and prevents complications, especially in reinterventions, thyroiditis, cancer and cervical lymphadenectomy (4,(11)(12)(13)(14)(15)(16)(17)(18)(19)

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Rare chondrosarcoma of the breast treated with quadrantectomy instead of mastectomy: A case report

Cited by 16 publications

References 22 publications

Primitive sarcoma of the breast: new insight on the proper surgical management

Primitive sarcoma of the breast: new insight on the proper surgical management

Vantagens da técnica de quadrantectomia em cadelas com neoplasias mamárias

Use of loupes magnification and microsurgical technique in thyroid surgery: ten years experience in a single center

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