Multidetector CT improving surgical outcomes in breast cancer (MISO-BC): A randomised controlled trial.

Background: Early diagnosis of malignant axillary nodes in breast cancer guides the extent of axillary surgery: patients with known axillary malignancy receive a more extensive single operation at the same time as surgery to their breast. A multicentre randomised controlled trial assessed whether a Computed Tomography (CT) scan of the axilla could more accurately diagnose malignant axillary lymph node involvement in patients with newly diagnosed breast cancer when compared to usual care.

Methods: Patients with newly diagnosed breast cancer (identified via screening and symptomatic pathways) at two NHS Trusts in the North East of England were recruited and randomised in equal numbers.

Immediate post-parathyroidectomy stridor resolved with intravenous calcium.

A 73-year-old woman underwent an uncomplicated focused parathyroidectomy for an adenoma. Immediately after extubation she developed respiratory distress and her airway became compromised. No obvious cause could be found for the stridor and no response was obtained from nebulised adrenaline (norepinephrine).