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At least 19 recordsLinked to original sources
PubMed1992

A prospective randomized trial of single versus multiple drains in the axilla after lymphadenectomy.

Increasing duration and amount of postoperative fluid formation after axillary lymphadenectomy delays final healing. We postulated that multiple drains (instead of a single drain) might decrease postoperative fluid accumulation by their greater proximity to points of leakage. We randomized 65 women with clinical stage I or II carcinoma of the breast to single or multiple drains. They were stratified for axillary dissection or modified radical mastectomy. For axillary dissection, randomization to multiple drains meant placement of four catheters in the axilla, and randomized to the single drain, one catheter in the axilla. For modified radical mastectomy, the patients randomized to multiple drains received four catheters in the axilla and one catheter under the inferior flap; the patients randomized to single drains had one catheter in the axilla and one catheter under the inferior flap. All catheters exited separately. The two arms (single versus multiple drains) were determined to be homogeneous in other variables that may affect postoperative fluid formation--age, size of the breast, weight, height, obesity, presence of previous surgical biopsy, excision of pectoralis minor muscle, excision of thoracodorsal complex, level of axillary dissection, number of lymph nodes, number and proportion of positive lymph nodes and whether or not the dominant hand was on the side operated upon. Single versus multiple drains had no clinically significant effect on the amount or duration of drainage, as an inpatient or outpatient, or total. We recommend a single drain to the axilla after lymphadenectomy.

Adult↗
PubMed1976

111Indium-bleomycin breast and axilla imaging.

111Indium-Bleomycin (111In-Blm), a new radiopharmaceutical, was administered intravenously to 37 patients with benign and malignant breast lesions. Early and delayed images of both the breasts and axillae were made, and results were correlated with physical examination, histopathology of the excised lesion, mammography, and thermography. In 18 patients with malignant disease, clinical examination of the breast and axilla correlated with histopathology in 78 and 54% of the cases, respectively. Images of the breast were accurate (true positives) in 83% of the cases. Images of the axilla were accurate in 62% of the cases. Mammography was correct and suggested malignancy in 88%, and thermography in 73% of the cases. In 19 patients with benign breast lesions, clinical examination of the breast and axilla correlated with histopathology in 68 and 95% of the cases, respectively. Scans of the breast and axilla were correct (true negative) 79 and 95% of the time, respectively. Mammography was correct, and suggested benignancy, in 53% and thermography in 25% of the cases. Imaging of the breasts using 111In-Blm appears to be as accurate as physical examination and mammography for palpable benign and malignant breast tumors. It is less accurate than mammography for microscopic malignancies. Axillary imaging does not appear to be worthwhile because many axillary metastases are too small for detection with current nuclear medicine instrumentation.

Adolescent↗
PubMed1992

The role of diagnostic CT scanning of the brachial plexus and axilla in the follow-up of patients with breast cancer.

In order to assess the value of computed tomographic scanning of the axilla and brachial plexus in the management of patients with arm symptoms following treatment for breast cancer, the case notes and diagnostic films of 102 such patients who underwent scanning between 1985 and 1990 at this institution were analysed retrospectively. The clinical indications for requesting computed tomography (CT) of the brachial plexus and axilla included arm oedema (52 patients, 51%), brachial plexus neuropathy (73 patients, 72%), and/or the presence of a palpable axillary mass (18 patients, 18%). Of 102 CT scans, 80 showed either no abnormality (31 patients, 30%), or axillary fibrosis (49 patients, 48%), and 22 (21%) showed radiological evidence of recurrent tumour. Only 4 of 84 patients with no palpable mass had computed tomographic evidence of occult recurrent tumour; all of these had concurrent evidence of distant metastatic disease (lung, liver, bone). Patients have been followed up for from between 1 and 15 years from diagnosis (median 5.5 years). The extremely low yield of tumour recurrence on computed tomographic scanning in the absence of a palpable axillary mass (4/84 patients, 5%; 95% CI 1-12), cannot justify CT as a method of screening for clinically occult axillary relapse in patients with arm symptoms following axillary surgery and radiotherapy for breast cancer. Computed tomographic scanning in these patients should only be employed to confirm the clinical suspicion of tumour as a baseline prior to further treatment.

Axilla↗
PubMed1975

Surgical treatment of hidradenitis suppurativa of the axilla.

We review our surgical experience with hidradenitis suppurativa of the axilla at Cook County Hospital during the years 1963 to 1972. The operation for this entity described by Pollock et al has (1) reduced the length of hospitalization, (2) increased the rate of primary healing and reduced the period of secondary healing, (3) allowed a great amount of tissue to be excised, (4) permitted both axillae to be operated on at once (without incapacitating the patient), (5) avoided the need for skin grafting, and (6) has had less morbidity for those patients in whom primary healing is not achieved. We believe the method reported by Pollock et al is now the treatment of choice for this disease.

Axilla↗
PubMed1976

Multiple lymphangiomas of the neck, axilla, mediastinum, and bones in an adult.

Whereas lymphangiomas of the neck, axilla, or mediastinum are not uncommon in children, they are rarely found in the adult, and primary lymphangioma of bone is very rare. The authors report a case of multiple lymphangiomas of the neck, axilla, mediastinum, and bones in a 34-year-old man, which they believe to be only the second such case reported thus far.

Adult↗
PubMed1992

[Bilateral absence of the quadrangular space of the axilla].

In the 1988 student course on gross anatomy dissection of cadavers at Iwate Medical University School of Medicine, two cases of the absence of the quadrangular space of the axilla were found bilaterally in a 92-year-old female who had died of heart failure. The cases were investigated anatomically. The tendons of insertion of the latissimus dorsi and the teres major muscles and the tendon of origin of the long head of the triceps brachii muscle were united, forming a conjoint tendon that attached to the infraglenoid tubercle of the scapula and the lower part of the anatomical neck of the humerus adhering to the articular capsule of the shoulder joint. The subscapularis muscle was normal except that a muscular bundle arose from the conjoint tendon and inserted to the lesser tubercle of the humerus and the crest continuing down from the tubercle. A part of the conjoint tendon was covered by the insertion of the subscapularis muscle, and there was no space between the conjoint tendon and the insertion of the subscapularis muscle. The teres major muscle was poorly developed, but the area of origin was rather wide and arose from both the dorsal and costal surfaces of the scapula. The anatomical features of the latissimus dorsi and the long head of the triceps brachii muscles were normal except for the insertion of the former and the origin of the latter. The triangular space of the axilla was found to be surrounded by the conjoint tendon, teres major muscle, and the lateral border of the scapula covered by the subscapularis and the teres minor muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1976

Evaluation of dissection of the axilla in modified radical mastectomy.

Fifty consecutive unselected patients with infiltrating carcinoma of the breast underwent radical mastectomy in two consecutive stages. The initial operation was a modified radical mastectomy, with preservation of the pectoral muscles, and the second stage, a procedure to transform the initial operation into a standard radical mastectomy. An analysis of the location and the number of the lymph nodes recovered in the two stage operation shows that a so-called modified radical mastectomy is inadequate to ensure the clearing of the axilla. Lymph nodes were recovered at the second stage of the operation in 36 patients, and seven of these patients had metastasis. Modified radical mastectomy was effective in erradicating the lymph nodes of the lower part of the axilla but inadequate for lymph nodes at levels II and III and, especially, the interpectoral lymph nodes.

Adult↗
PubMed1978

Postirradiation sarcoma (malignant fibrous histiocytoma) of axilla.

A case is reported of a patient who developed a histologically unusual sarcoma in the axilla and chest wall 8 years after receiving radiation therapy (6500 rad) for carcinoma of the breast. This sarcoma showed light- and electron-microscopic features of a malignant fibrous histiocytoma, a tumor not documented among 24 previously reported cases of postirradiation sarcoma following the diagnosis of breast carcinoma. In addition, the literature is reviewed and discussed regarding postirradiation sarcoma in general following breast carcinoma.

Adult↗
PubMed1992

Breast carcinoma: periodicity in presentation of metastatic tumour growth in the axilla.

The clinical value of assessment of tumour load in the axilla in the treatment of breast cancer patients has stood the test of time. Much information is available on its extent and characteristic distribution but, in contrast, little is known of the biological factors that may control the timing of the metastatic phenomenon. There is recent circumstantial evidence that such factors may exist and this prompted the present detailed study of axillary metastases from a series of 437 consecutive cases of breast carcinoma. Evidence of such factors was found here also: the excess of micrometastases in cases coming to operation in the second half of the year was highly significant (P less than 0.001) and is consistent with a synchronized start to the metastatic process. The total metastatic pattern in the material further indicated that the process may show periods of inactivity, i.e. periods when new colonies are not recruited. Mechanisms controlling this periodicity could theoretically be light-mediated, opening up new possibilities in the development of anti-metastatic treatment regimes.

Axilla↗
PubMed1992

Reassessment of tumour-load in the axilla in patients with breast cancer: a preliminary report.

The tumour-load in the axilla of breast cancer patients is classically measured from the number of tumour-bearing nodes present, which is then used to assess prognosis. This preliminary morphometric study on 73 cases of breast carcinoma for which standardized axillary dissection specimens were available shows that the total tumour load, measured from the sum of the tumour area (cm2) in hilar nodal sections, gives a redistribution of the patients; one that may provide better prognostic information in particular in women with a high tumour load. In those with four or more nodes involved the actual number is said to give little prognostic discrimination at 4 years post-operatively, as was demonstrated in this series. In contrast, using data from the same patients, the risk of death by this time increased steadily with increasing tumour area.

Axilla↗
PubMed1975

The sexual significance of the axillae.

The present paper will review the existing material on the relationships between the axillae and sexuality, present examples of the relationship from clinical practice, everyday life, art, anthropology, mythology, and literature, and consider the relevant human and primate physiological knowledge.

Anthropology↗
PubMed1992

Fatal tracheal compression after haemorrhage into the axilla.

We report a case of fatal ventilatory obstruction as a result of haemorrhage into the axilla after a comminuted spiral fracture of the upper one-third of the humerus. Guidelines are presented as to the early recognition of such complications and their subsequent management.

Aged↗
PubMed1978

Ten years of experience in managing patients with burn contractures of axilla, elbow, wrist, and knee joints.

An analysis of 625 patients who had sustained burns across the axillae, elbows, wrists, or knee joints indicates that the use of splints and pressure across these joints will not only greatly decrease the incidence of contractures but will also reduce the frequency and need for release operations. However, these appliances must be used for at least 6 months (longer, if possible), if substantial benefits are to be obtained.

Axilla↗
PubMed1975

Abrasio axillae in hyperhidrosis.

Forty-one patients with hyperhidrosis axillae were operated on. The subcutaneous curettage in 20 patients was compared with radical excision in 21 patients. Comparison of the results of both operations disclosed no difference in the elimination of the sweat secretion, but the method of curretage is superior, because it can be repeated if necessary and leaves practically no scars.

Axilla↗
PubMed1976

Surgical treatment of hyperhidrosis axillae.

58 patients have been operated on for axillary hyperhidrosis by excision of the skin and subcutaneous tissue. The hyperhidrotic area was determined by application of a crêpe paper in the axilla. Either 60% or 90% of the hyperhidrotic area was excised, using a bat-like pattern. Only after excision of 90% of the hyperhidrotic area acceptable results were achieved. In a series of 22 patients with 90% excision bilaterally 18 had excellent results, three were good, and one was poor. The entire series was without complication. The advantage of this technique is its simplicity, freedom from complication, performance on an out-patient basis, and short convalescent time.

Adolescent↗