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Biomedical subjects

G Querci della Rovere

Publications and source records attributed to G Querci della Rovere.

17 recordsLinked to original sources
PubMed2006

Management of the axilla in women with breast cancer.

There remain several outstanding questions relating to management of the axilla in women with early stage breast cancer. This paper summarises the outcome of a national debate aimed at discussing certain key issues including a) whether axillary dissection has any survival advantage b) is an axillary staging procedure always necessary c) what is the optimum method of staging the axilla and d) whether an axillary dissection is always necessary in cases of a positive sentinel node. Electronic voting was undertaken at the beginning and end of the debate and results are compared and presented herein.

Axilla↗
PubMed2005

A prospective randomised study to evaluate the effectiveness of standard 23 gauge fine needle, compared with a thinner 27 gauge needle for breast cytology.

The aim of this study was to determine whether a 27 gauge needle could be used to obtain adequate cytology with less discomfort to the patient. Two types of needles were compared-23 gauge (blue) needle versus 27 gauge very fine needle. The cytology specimen was assessed for quality in terms of adequacy for diagnosis. Ninety samples were randomised into this study. The quality of samples was similar in both groups; there was no statistical difference in the quality of samples obtained. The 27 gauge needle produced two inadequate samples (4.4%), whereas there were no inadequate samples with the 23 gauge needle. There was no statistical difference in the amount of blood on the slide between the two groups. The pain scores were significantly better with the finer needle (P=0.004). This study provides evidence that the 27 gauge FNAC is suitable for obtaining cytology in palpable breast lumps.

Biopsy, Fine-Needle↗
PubMed2003

An audit of the incidence of arm lymphoedema after prophylactic level I/II axillary dissection without division of the pectoralis minor muscle.

UNLABELLED: Lymphoedema is reported to occur in approximately one in four women following curative treatment for breast cancer. Reported rates are almost exclusively for level 1,2,3 axillary clearance with few data for the current practice of level 1,2 dissections. Swelling can affect the whole upper limb but frequently will remain restricted to hand, forearm or upper arm. The aims of this study were to determine incidence after level 1,2 dissection, degree and site of swelling and risk factors which might determine such incidences. Results were available on 198 patients. The cumulative prevalence of lymphoedema after level 1,2 dissections was 14% in the arm, 12% in the forearm and 16% in the hand, assuming a circumference difference of more than 5% indicated lymphoedema. Moderate lymphoedema representing more than 10% circumference difference was found in 1% (arm), 3.5% (forearm) and 0.5% in the hand. Risk factors for lymphoedema were experience of the surgeon (upper arm only), dominant limb (forearm only) and right-sided cancer treatment (for hand only). When lymphoedema in any site was considered, right-sided treatment and nodal status were independently significant. CONCLUSIONS: This study demonstrates that lymphoedema is a common complication following level 1,2 dissection. Whole limb volume is often considered the main outcome measure for detecting lymphoedema and determining success of treatment, yet swelling may be restricted to regions of the limb and site specific circumference measurements are therefore recommended. Pre- and postoperative circumference measurements are likely to be the most sensitive way of determining presence of lymphoedema following surgery for breast cancer.

Adult↗
PubMed2002

Ipsilateral local recurrence of breast cancer: determinant or indicator of poor prognosis?

The importance of ipsilateral local recurrence within a conserved breast depends on the micrometastatic environment at the time of initial clinical presentation. In the absence of micrometastases, local recurrence would be a determinant of distant disease; however, in the presence of micrometastases, it represents a marker of distant relapse. Maximum locoregional treatment at primary diagnosis would be appropriate in the former group, whereas minimum treatment would be sufficient in the latter group, with full treatment prescribed at the time of local recurrence. As an indicator of poor prognosis, the presence of local recurrence permits a more selective approach to therapies that would otherwise result in overtreatment for some patients. We, therefore propose a trial that compares conventional treatment with minimum therapy at presentation plus maximum therapy at local relapse in postmenopausal women with small tumours.

Aged↗
PubMed2001

Eyelid metastasis.

Explore the source record for details and available documents.

Breast Neoplasms↗
PubMed2001

Predicting axillary lymph node metastases in patients with T1 infiltrating ductal carcinoma of the breast.

Factors which can predict an increased risk of axillary metastases in cases of T1 breast cancer could help to identify those patients most likely to benefit from axillary surgery. This pragmatic study aimed to examine the ability of commonly reported tumour pathological features to predict axillary metastases. All cases of T1 infiltrating ductal carcinoma excised with ipsilateral axillary nodes over a 7 year period were reviewed retrospectively. Of the 639 cases, 197 (30.8%) had positive nodes. Axillary metastases were found with 66.3% of tumours showing vascular invasion but only 16.0% of those without vascular invasion. Following multivariate analysis, vascular invasion and tumour size were found to be independent predictors of positive nodes but tumour grade was not. The decision to perform axillary dissection in T1 breast cancer could be based on the presence of vascular invasion and the size of the primary tumour.

Journal Article↗
PubMed1987

Pleomorphic lipoma of the dermis.

A case of pleomorphic lipoma is described. The neoplastic tissue developed exclusively within the dermis and characteristically involved the fibrous root sheaths of hair follicles, where several layers of lamellar collagen encircled the follicles and entrapped atypical spindle and multinucleated cells. A possible origin of this tumour in the adventitial dermis is postulated.

Aged↗
PubMed1986

Risk of lymphoedema following the treatment of breast cancer.

The incidence of lymphoedema was studied in 200 patients following a variety of treatments for operable breast cancer. Lymphoedema was assessed in two ways: subjective (patient plus observer impression) and objective (physical measurement). Arm volume measurement 15 cm above the lateral epicondyle was the most accurate method of assessing differences in size of the operated and normal arm. Arm circumference measurements were inaccurate. Subjective lymphoedema was present in 14 per cent whereas objective lymphoedema (a difference in limb volume greater than 200 ml) was present in 25.5 per cent. Independent risk factors contributing towards the development of subjective late lymphoedema were the extent of axillary surgery (P less than 0.05), axillary radiotherapy (P less than 0.001) and pathological nodal status (P less than 0.10). The risk of developing late lymphoedema was unrelated to age, menopausal status, handedness, early lymphoedema, surgical and radiotherapeutic complications, total dose of radiation, time interval since presentation, drug therapy, surgery to the breast, radiotherapy to the breast and tumour T stage. The incidence of subjective late lymphoedema was similar after axillary radiotherapy alone (8.3 per cent), axillary sampling plus radiotherapy (9.1 per cent) and axillary clearance alone (7.4 per cent). The incidence after axillary clearance plus radiotherapy was significantly greater (38.3 per cent, P less than 0.001). Axillary radiotherapy should be avoided in patients who have had a total axillary clearance.

Axilla↗