Clinical Factors Affecting the Therapeutic Efficacy of Evening Primrose Oil on Mastalgia.

Background: Saturated fatty acid esters may cause mastalgia via hypersensitivity of breast epithelium to circulating hormones. Evening primrose oil (EPO) may restore the saturated/unsaturated fatty acid balance and decrease sensitivity to steroidal hormones or prolactin. Conflicting results exist regarding EPO treatment for mastalgia.

Oncologic safety of nipple-sparing mastectomy in patients with short tumor-nipple distance.

Background: There is a tendency to avoid nipple-sparing mastectomy (NSM) when a tumor-nipple distance (TND) is <2 cm due to the risk of occult nipple involvement. The purpose of the study was to determine whether the patients who undergo NSM with immediate reconstruction are oncologically safe when TND is <2 cm.

Methods: Patients who underwent NSM followed by immediate reconstruction for breast cancer were retrospectively analyzed.

Is human papillomavirus associated with breast cancer or papilloma presenting with pathologic nipple discharge?

Purpose: There are little data on the presence or interaction of human papillomavirus (HPV) in intraductal papilloma or Breast cancer (BC) presenting with pathologic nipple discharge (PND). The study aimed to determine whether the HPV-genotypes are identifiable in papilloma or carcinoma of the breast by real-time PCR with broad-spectrum genotyping.

Methods: Formalin-fixed-paraffin-blocks obtained from the patients who were suffering from PND and underwent ductoscopic papilloma extraction (n = 27) or segmental/total mastectomy for cancer diagnosis (n = 18).

The role of molecular biomarkers for predicting adjacent breast cancer of Atypical Ductal Hyperplasia diagnosed on core biopsy.

Background: Atypical Ductal Hyperplasia (ADH) is a disease of the proliferative breast lesion characterized with atypia and when diagnosed on core needle biopsy (CNB), excisional biopsy is the current management to exclude adjacent cancer, which may found 10 to 20%.

Objective: The purpose of the study is to investigate the role of biomarkers on surgical decision after the diagnosis of ADH on CNB.

Methods: Patients with pure ADH on core biopsy were retrospectively selected, and categorized according to final pathology after excision into three groups: Group I (n: 39) ADH; Group II (n: 27) ductal carcinoma in situ (DCIS), and Group III (n: 9) invasive cancer (IC).

Exploring breast with therapeutic ductoscopy.

Breast lesions are thought to arise mostly from the epithelium of ductal lining. Conventional imaging could only show indirect images of suspected lesions which are confirmed by percutaneous biopsies. However, ductoscopy provides direct images of the ductal epithelium which is the source of most malignant and papillary lesions.

Interventional ductoscopy for pathological nipple discharge.

Background: Despite the low likelihood of malignancy, it is recommended that patients who have pathologic nipple discharge (PND) undergo duct excision. Intraductal papilloma is well-known most frequent cause of PND. Our goal is to determine whether the ductoscopic retrieval of a solitary papilloma is feasible and/or therapeutic for patients with PND.

Optimizing surgical margins in breast conservation.

Adequate surgical margins in breast-conserving surgery for breast cancer have traditionally been viewed as a predictor of local recurrence rates. There is still no consensus on what constitutes an adequate surgical margin, however it is clear that there is a trade-off between widely clear margins and acceptable cosmesis. Preoperative approaches to plan extent of resection with appropriate margins (in the setting of surgery first as well as after neoadjuvant chemotherapy,) include mammography, US, and MRI.

Gamma probe (99m)Tc-pertechnetate assisted completion thyroidectomy vs conventional thyroidectomy in differentiated thyroid carcinoma.

Patients undergoing partial thyroidectomy for benign diseases may need re-operation if differentiated thyroid carcinoma (DTC) is detected on histopathology. The aim of this study was to determine if using gamma probe during the above surgery in a procedure called: gamma probe completion thyroidectomy (GPCT) could support the diagnosis of DTC tissue and offer an advantage in the surgical treatment of DTC patients. We have studied 100 patients who after bilateral subtotal thyroidectomy for benign disease in several hospitals, were found to have DTC histopathologically and referred to our clinic for subsequent re-operation.

Systemic inflammatory response after Kugel versus laparoscopic groin hernia repair: a prospective randomized trial.

Background: Kugel repair, a minimally invasive technique, has become an alternative to laparoscopic groin hernia repair, but the technique has not been adequately evaluated by assessment of objective parameters. A prospective randomized clinical study was carried out to compare the systemic inflammatory response to surgical trauma and clinical outcomes in patients who underwent groin hernia repair by the Kugel and totally extraperitoneal (TEP) laparoscopic methods.

Methods: Forty consecutive patients admitted for unilateral groin hernia were randomized to Kugel (n = 20) or TEP (n = 20) repair under general anesthesia.

Scarless endoscopic papillomectomy of the breast.

Background: Efforts have been made to improve minimally invasive breast surgery techniques, resulting in less tissue damage and much better cosmetic results. We evaluated the therapeutic value of a new scarless operation, endoscopic papillomectomy (EP), in patients with pathologic nipple discharge (PND).

Methods: Breast ductoscopy was performed on 126 women with PND.