An independent assessment of the 7 nomograms for predicting the probability of additional axillary nodal metastases after positive sentinel lymph node biopsy in a cohort of British patients with breast cancer.

Introduction: Axillary lymph node dissection (ALND) is currently the recommended procedure in patients with tumor-positive sentinel lymph node biopsy (SLNB). A significant proportion of patients with positive SLNs will not have any additional metastases in nonsentinel lymph nodes (NSLNs). Predictive nomograms could identify a subgroup of patients with low or high risk of further disease in whom completion ALND can be avoided or recommended.

International multicenter tool to predict the risk of four or more tumor-positive axillary lymph nodes in breast cancer patients with sentinel node macrometastases.

Recently, many centers have omitted routine axillary lymph node dissection (ALND) after metastatic sentinel node biopsy in breast cancer due to a growing body of literature. However, existing guidelines of adjuvant treatment planning are strongly based on axillary nodal stage. In this study, we aim to develop a novel international multicenter predictive tool to estimate a patient-specific risk of having four or more tumor-positive axillary lymph nodes (ALN) in patients with macrometastatic sentinel node(s) (SN).

International multicenter tool to predict the risk of nonsentinel node metastases in breast cancer.

Background: Axillary treatment of breast cancer patients is undergoing a paradigm shift, as completion axillary lymph node dissections (ALNDs) are being questioned in the treatment of patients with tumor-positive sentinel nodes. This study aims to develop a novel multi-institutional predictive tool to calculate patient-specific risk of residual axillary disease after tumor-positive sentinel node biopsy.

Methods: Breast cancer patients with a tumor-positive sentinel node and a completion ALND from five European centers formed the original patient series (N = 1000).

A biospectroscopic interrogation of fine needle aspirates points towards segregation between graded categories: an initial study towards diagnostic screening.

Fine needle aspirates (FNAs) of suspicious breast lesions are often used to aid the diagnosis of female breast cancer. Biospectroscopy tools facilitate the acquisition of a biochemical cell fingerprint representative of chemical bonds present in a biological sample. The mid-infrared (IR; 4,000-400 cm(-1)) is absorbed by the chemical bonds present, allowing one to derive an absorbance spectrum.

Prevalence and risk factors of cesarean section in a population of Tunisian diabetic pregnant women.

Aim: To determine the rate of and indication of cesarean section among women with preexisting and gestational diabetes mellitus compared with glucose-tolerant women.

Methods: from case-control study of 400 Tunisian pregnant women (200 in group diabetes and 200 in group control) seen over a 5-year period for medical management, women who had a cesarean section were identified and the reason for the section determined from a review of the medical record. A control group of women who had a section were obtained from an existing data-base of glucose-tolerant women.

Surgical clips in planning the electron boost in breast cancer: a qualitative and quantitative evaluation.

Purpose: To evaluate, qualitatively and quantitatively, the role of surgical clips in planning the tumor bed electron boost in patients undergoing breast conserving surgery and radiotherapy.

Methods And Materials: In 50 patients, the excision cavity boundaries were marked by clips at surgery. The electron boost field was first planned using clinical information, aiming to achieve a margin of 2 cm, and its accuracy evaluated by screening the surgical clips and, if necessary, adjusting the field to encompass all clips with 2 cm margins.

The selective use of fine catheter peritoneal cytology and laparoscopy reduces the unnecessary appendicectomy rate.

The effect of a management protocol incorporating the selective use of fine catheter peritoneal cytology (FCPC) and laparoscopy on the unnecessary appendicectomy rate was studied in adult patients (> or = 16 years) treated at one district general hospital over an 11-month period. Appendicectomy was performed on 62 adult patients managed according to this protocol, six (10%) of whom had a histologically normal appendix and no other acute condition requiring surgery. A further 57 patients underwent appendicectomy after standard clinical assessment and investigation without the use of FCPC or laparoscopy.

Role of fine catheter peritoneal cytology and laparoscopy in the management of acute abdominal pain.

Laparoscopy and fine catheter peritoneal cytology (FCPC) have been advocated as aids in the assessment of acute abdominal pain. In all, 411 patients admitted to a district general hospital during a 10-month period were managed using a standard protocol incorporating these techniques. After initial assessment by a surgical registrar, 151 patients were excluded from further progress through the protocol (age less than 16 years, definite diagnosis made or contraindication to FCPC.