Climate Therapy: Sustainability Solutions for Breast Cancer Care in the Anthropocene Era.

Climate change is the greatest threat to human existence. Currently it impacts breast cancer care by disrupting treatment, by food poverty and economic hardship and through fossil fuel pollution which increases breast cancer incidence. These impacts are greatest in those already experiencing deprivation.

The impact of the COVID-19 pandemic on symptomatic breast cancer presentations in an Irish breast cancer unit: a retrospective cohort study.

Background: The coronavirus-19 (COVID-19) pandemic caused delays in the diagnosis and management of breast cancer which may have affected disease presentation. The aim of this study was to compare rates of metastatic disease, tumour characteristics and management in breast cancer patients diagnosed before and after the onset of COVID-19.

Methods: A retrospective chart review was conducted on patients in a university teaching hospital who were diagnosed with invasive symptomatic breast cancer in 2019 (prepandemic control group) and in 2020, 2021, and 2022 (pandemic study groups).

Patients' and doctors' views and experiences of the patient safety trajectory of breast cancer care.

Introduction: Successful breast cancer outcomes can be jeopardised by adverse events. Understanding and integrating patients' and doctors' perspectives into care trajectories could improve patient safety. This study assessed their views on, and experiences of, medical error and patient safety.

Dealing with digital paralysis: Surviving a cyberattack in a National Cancer center.

Introduction: Cyberattacks represent a growing threat for healthcare delivery globally. We assess the impact and implications of a cyberattack on a cancer center in Ireland.

Methods: On May 14th 2021 (day 0) Cork University Hospital (CUH) Cancer Center was involved in the first national healthcare ransomware attack in Ireland.

Smart needle electrical bioimpedance to provide information on needle tip relationship to target nerve prior to local anesthetic deposition in peripheral nerve block (USgPNB) procedures.

Ultrasound guided peripheral nerve block (USgPNB) refers to anaesthetic techniques to deposit local anesthetic next to nerves, permitting painful surgery without necessitating general anesthesia. Needle tip position prior to local anesthetic deposition is a key determinant of block success and safety. Nerve puncture and intra-neural injection of local anesthetic can cause permanent nerve injury.

The positive predictive value of vacuum assisted biopsy (VAB) in predicting final histological diagnosis for breast lesions of uncertain malignancy (B3 lesions): A systematic review & meta-analysis.

Introduction: High-risk or B3 breast lesions are considered lesions of uncertain malignant potential and comprise between 5 and 12% of initial biopsy results. We sought to perform a systematic review and meta-analysis of studies published within the last twenty years to determine the pooled Positive Predictive Value (PPV) of VAB in selected B3 lesions.

Methods: The study report is based on the guidelines of PRISMA and Meta-Analysis of Observational Studies in Epidemiology.

Association of Circulating Tumor DNA With Disease-Free Survival in Breast Cancer: A Systematic Review and Meta-analysis.

Importance: Fragmented DNA is continuously released into the circulation following apoptosis and necrosis of both cancerous and noncancerous cells; when it is released by cancer cells, it is specifically known as circulating tumor DNA (ctDNA). Previous studies have suggested that ctDNA can reflect tumor burden and guide potential therapeutic targets.

Objective: To determine the association of ctDNA with breast cancer disease-free survival (DFS) and progression-free survival in early, locally advanced, and metastatic breast cancer.

The LOCalizer Radiofrequency Identification System: An Effective New Technology for Localizing Non-Palpable Breast Lesions for Surgery.

Breast screening has decreased morbidity and mortality due to detection of early, non-palpable breast cancers. One of the challenges of performing breast-conserving surgery on non-palpable breast tumours is accurate localization of the cancer. We aimed to perform a feasibility study to examine the outcomes associated with the introduction of a novel radiofrequency identification system (RFID) called LOCalizer as an alternative to traditional wire-guided localization.

Can the Neutrophil to Lymphocyte Ratio Predict Complete Pathologic Response to Neoadjuvant Breast Cancer Treatment? A Systematic Review and Meta-analysis.

The systemic inflammatory response plays a role in tumor progression and development. The neutrophil to lymphocyte ratio (NLR) is a biochemical marker of systemic inflammation and is increasingly gaining appreciation for its prognostic role in predicting breast cancer outcomes. Previous research has demonstrated that patients who achieve a complete pathologic response (pCR) to neoadjuvant breast cancer treatment have a more favorable disease-free survival.

Evaluation of the effect of the accordion suturing technique on wound lengths in breast cancer surgery: a randomised clinical trial.

Background: Cosmetic outcomes and scar lengths remain important considerations in breast cancer surgery. Suturing techniques should decrease scar tissue formation and provide good cosmetic results. The use of an accordion suturing technique may result in decreased surgical wound lengths and better cosmetic outcomes.

Sentinel lymph node biopsy is not warranted following a core needle biopsy diagnosis of ductal carcinoma in situ (DCIS) of the breast.

Introduction: The role of sentinel lymph node biopsy (SLNB) in ductal carcinoma in situ (DCIS) is controversial. This study evaluates the risk of clinically relevant SLN metastasis following a core needle biopsy (CNB) diagnosis of pure DCIS.

Materials And Methods: Cases that underwent SLNB following a CNB diagnosis of pure DCIS at our institution over a 4.

Mycotic aneurysm of the popliteal artery secondary to Streptococus pneumoniae: a case report and review of the literature.

Introduction: Cases of true mycotic popliteal artery aneurysm are rare. Presentation is variable but invasive and non-invasive investigations collectively facilitate diagnosis and guide operative procedures. Definitive treatment generally utilizes surgical intervention with excision and reconstruction using autologous vein graft.

Cylindroma of the breast: a case report and review of the literature.

Cylindroma of the breast is a very rare lesion which is morphological and immunophenotypically identical to benign dermal cylindroma. We report a breast cylindroma in a previously healthy 62 year old female detected through a national breast screening program. The patient had no significant family or past medical history, and specifically no history of breast or skin diseases.

A prospective feasibility trial to determine the significance of the sentinel node gradient in breast cancer: a predictor of nodal metastasis location.

Background: Sentinel lymph node (SN) biopsy is standard for breast cancer staging, but SN dye gradients and their significance have never been characterized. If predictive of SN metastasis location, their use for focused pathology examination might improve intraoperative imprint cytology sensitivity.

Methods: This prospective trial enrolled clinically lymph node-negative patients with invasive breast cancer not undergoing neoadjuvant chemotherapy.

The dilemma of DCIS.

The increasingly frequent diagnosis of ductal carcinoma in situ (DCIS) presents a major clinical dilemma. Our inability to predict which DCIS will progress to invasive cancer or the time interval in which recurrent DCIS or invasive cancer will occur has resulted in treatments ranging from mastectomy to excision and observation being offered to patients. Four randomized trials have demonstrated that the use of radiation reduces the risk of local recurrence by about 50% in women with DCIS.

Daily diurnal variation in admissions for ruptured abdominal aortic aneurysms.

Background: Many vascular events, such as myocardial infarction and cerebrovascular accident, demonstrate a circadian pattern of presentation. Blood pressure is intimately related to these pathologies and is the one physiological variable consistently associated with abdominal aortic aneurysm rupture. It also demonstrates a diurnal variation.

Ductal carcinoma in situ--current management.

This article summarizes the modern evidence-based management of ductal carcinoma in situ. The data addressing the surgical issues, including indications for mastectomy and the use of sentinel node biopsy, are presented. The randomized trials examining the role of radiation therapy after breast-conserving surgery and the use of tamoxifen in ductal carcinoma in situ are discussed.

Prospective study of use of perioperative antimicrobial therapy in general surgery.

Background: Perioperative antimicrobial therapy has demonstrated efficacy in reducing the rate of surgical site infections in clinical trials. With the emergence of antibiotic resistance, the risk of reaction, and the inevitable financial repercussions, use of prophylactic antibiotics is not a panacea, and their misuse may have considerable implications. The aim of this study was to assess the use of antibiotics in the perioperative period in both general and vascular surgery procedures.

The effects of low-frequency endo-anal electrical stimulation on faecal incontinence: a prospective study.

Background And Aims: Faecal incontinence is a distressing problem that is often not amenable to surgical correction. Chronic low-frequency electrical stimulation of damaged axons is thought to reduce synaptic resistance, increase the size of motor units by axonal sprouting and increase the rate of conduction of the pudendal nerve. The aim of this study was to prospectively evaluate the effect of chronic low-frequency endo-anal electrical stimulation on faecal incontinence using a home-based unit and hospital-supervised therapy.

Trichotillomania.

Trichotillomania is a relatively uncommon condition that classically occurs in young females. It can result in trichobezoar formation, which is usually managed successfully by surgical intervention, although rarely it can be fatal. This article presents a brief review of trichotillomania.