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Biomedical subjects

T Styblo

Publications and source records attributed to T Styblo.

8 recordsLinked to original sources
PubMed2001

Sentinel node staging of early breast cancer using lymphoscintigraphy and the intraoperative gamma detecting probe.

Lymphoscintigraphy combined with intraoperative gamma-probe detection of sentinel lymph nodes in patients with inoperable early primary breast cancers is effective for staging the disease. The clinical alternative is axillary lymph node dissection, which is a far more invasive procedure and is accompanied by significant morbidity. Accuracy of staging is enhanced by immunohistochemical staining of micrometastases, which pathologists can easily perform for one to three sentinel lymph nodes, but not for 20 to 30 nodes, using axillary dissection procedure. Optimum methodology is presented for performing sentinel lymph node imaging and is important for accurate identification of sentinel node(s).

Breast Neoplasms↗
PubMed2000

Sentinel node staging of early breast cancer using lymphoscintigraphy and the intraoperative gamma-detecting probe.

Sentinel node staging for breast cancer is increasingly used in place of axillary lymph node dissection but is not yet universally accepted. The problems of non-standardized methodologies and lack of consensus on the optimum techniques to identify sentinel nodes are being addressed. Complementary use of radionuclide imaging before surgery, intraoperative probe detection, and blue dye have yielded the best reported sensitivities for finding a sentinel node (94%). The importance of imaging is summarized as identifying sentinel node(s), distinguishing sentinel from secondary nodes, guiding surgical incision planning, and facilitating lower doses. The learning curve phenomenon, which applies to the surgeon and the nuclear medicine physician, has been recognized; measures to minimize it are being implemented. Radiation exposure to operating room and pathology personnel is very low; estimates of exposure to the surgeon's hands are 0.2% of the annual whole body dose received by every human being from natural background and cosmic sources.

Breast Neoplasms↗
PubMed1996

Autologous breast reconstruction with endoscopic latissimus dorsi musculosubcutaneous flaps in patients choosing breast-conserving therapy: mammographic appearance.

OBJECTIVE: The objective of this study was to define and evaluate mammographic changes in patients treated with breast-conserving therapy and a new reconstructive technique that uses autologous tissue from a latissimus dorsi musculosubcutaneous flap. MATERIALS AND METHODS: Of 20 patients who underwent either immediate or delayed endoscopic latissimus dorsi muscle flap reconstruction after lumpectomy, 13 also had postsurgery mammograms available for review. Radiographic findings assessed included skin thickening, density or radiolucency at the reconstruction site, density around the flap, fat necrosis, calcifications, and the presence of surgical clips. RESULTS: Mammograms for three patients (23%) revealed thickening that we believed was attributable to radiation therapy. No patient had increased density in the flap itself; all flaps were relatively radiolucent centrally (13/13; 100%). Mammograms revealed density around the rim of the flap in four patients (31%). This density was most likely secondary to latissimus dorsi muscle fibers and did not limit radiographic evaluation. One patient had calcifications, probably secondary to fat necrosis. No oil cysts were seen. In the majority of patients (11/13; 85%), surgical clips were visible. CONCLUSION: Endoscopic latissimus dorsi muscle flap reconstruction, previously used only for mastectomy patients, is now being used for improved esthetic outcome in selected patients who desire breast conservation. Our results indicate that the mammographic findings are predictable. The most common findings are relative radiolucency centrally, with or without density from muscle fibers around the edges of the area of tissue transfer. The transplanted musculosubcutaneous flap does not interfere with mammographic evaluation.

Adult↗
PubMed1995

Conservative treatment of early-stage breast cancer in a medically indigent population.

The compliance with a program of breast-conservation treatment for early-stage breast cancer and the results of that treatment among women treated between January 1983 and January 1992 was investigated in a large inner-city public hospital serving a primarily black population. Medical records and charts were reviewed for 25 consecutive patients with stage I and II breast cancer seen in consultation in the radiation oncology department. Of those 25 patients, 20 underwent lumpectomy and radiation therapy. Survival, disease-free survival, and local recurrence-free survival were computed using the Kaplan-Meier method. Compliance was evaluated based on time to complete the prescribed course of radiotherapy after a lumpectomy. Five-year local recurrence-free survival for stage I and II patients was 95% (confidence interval [CI]: 71% to 99%). Five-year overall survival for stage II patients was 71% (CI: 31% to 92%), and disease-free survival was 74% (CI: 36% to 91%). This study demonstrates that a program of breast-conservation treatment for early-stage breast cancer can be implemented with good results, excellent treatment compliance, and 100% follow-up in a population of medically indigent women.

Adult↗
PubMed1994

Conservative treatment of early-stage breast cancer. The Emory experience.

Between January 1983 and December 1991, 80 women with AJCC clinical stage I or II breast cancer were treated with conservative surgery and radiation therapy. Reexcision of the primary was performed in 40 breasts, and residual tumor was identified in 40% of these. Margins of resection were assessed in 80% and, of these, 46 patients had final margins of resection that were negative, 86% had axillary node dissection, 45 patients had histologically negative axillary nodes, and 24 had histologically positive axillary nodes. Of patients with histologically positive lymph nodes, 92% received systemic adjuvant treatment consisting of chemotherapy in 19/24 and tamoxifen in 14/24. Median follow-up was 34 months (range: 6-90 months). The adjusted 5-year actuarial Overall Survival for the group was 92%, and Disease-Free Survival was 80%. The 5-year Local Recurrence-Free Survival was 96%. The present study confirms the excellent results that can be obtained with conservative surgery plus radiation therapy.

Adult↗
PubMed1984

The effects of reversal of jejunoileal bypass operations on hepatic triglyceride content and hepatic morphology.

Obesity is associated with significant hepatic steatosis, inflammation, and cirrhosis. These changes may be accentuated by jejunoileal bypass operations. This study is intended to determine if reconstruction of jejunoileal bypass operations alters hepatic triglyceride content and hepatic morphology. Eighty-eight +/- 27 months after jejunoileal bypass, 26 patients underwent reconstruction for a variety of complications of the operation, including five patients with cirrhosis. At the time of reconstruction, hepatic triglyceride content was 132 +/- 13 mg/100 mg protein. After reconstruction, hepatic triglyceride content increased to 205 +/- 32 mg/100 mg protein in patients whose body weight increased and decreased to 84 +/- 6 mg/100 mg protein in patients whose body weight decreased. After reconstruction, hepatic inflammation decreased in 20 patients and hepatic fibrosis decreased in 17. These changes were not related to body weight changes. In five patients with cirrhosis at the time of reconstruction, one died of liver failure and hepatic morphologic findings improved in four after reconstruction of jejunoileal bypass operations. The results of this study suggest that reconstruction of jejunoileal bypass operations with weight loss or maintenance of body weight after reconstruction is associated with decreased fat in the liver. Approximately 65% of the patients will have improvement in hepatic morphologic parameters after reconstruction. Inflammation will be more greatly benefited than will fibrosis. In some patients, hepatic histologic abnormalities are unchanged or will progress despite reconstruction of jejunoileal bypass operations.

Adult↗