Eur J Gynaecol Oncol
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Eur J Gynaecol Oncol · Jan 2005
Comparative StudyUterine pathologies in patients undergoing tamoxifen therapy for breast cancer: ultrasonographic, hysteroscopic and histological findings.
To evaluate endometrial abnormalities by ultrasonography, hysteroscopy and biopsy in postmenopausal patients treated with tamoxifen as adjuvant therapy for breast cancer. ⋯ These results show that long-term tamoxifen therapy in breast cancer patients is associated with a higher incidence of uterine pathology. No significant relation has been documented between duration of treatment and grade of endometrial lesion (p > 0.05). Ultrasonography alone is useful in asymptomatic patients because it selects patients with increased endometrial thickness who should undergo hysteroscopy. Hysteroscopy is more accurate in detecting polyps, hyperplastic and neoplastic changes. Asymptomatic tamoxifen treated women should be evaluated as symptomatic patients.
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Eur J Gynaecol Oncol · Jan 2005
Detection of axillary metastases in breast cancer patients using ultrasound and colour Doppler combined with fine needle aspiration cytology.
The aims of this study were to evaluate the diagnostic value of ultrasonography and colour Doppler combined with fine needle aspiration (FNA) cytology for the detection of non-palpable axillary lymph node metastases in breast cancer patients. Forty patients with operable breast cancer (T1/T2), invasive carcinoma, not submitted to neo-adjuvant therapy, underwent axillary ultrasonography and colour Doppler preoperatively. FNA cytology was performed on axillary lymph nodes presenting ultrasonographic and/or Doppler suspicious features. ⋯ Ultrasound-guided FNA detected metastases in six out of 11 histologically node-positive patients. Sensitivity and specificity in this preliminary study was 55% and 100%, respectively. These are the preliminary results of a prospective study that has the purpose of reducing the sentinel node procedures in breast cancer patients with clinically negative axillae, but positive FNA cytology.
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Eur J Gynaecol Oncol · Jan 2005
Lymph node sampling is of prognostic value in early stage epithelial ovarian carcinoma.
The importance of lymph node involvement as a prognostic factor is still under debate. In the present study, the impact of surgical staging for prognosis in early stages of epithelial ovarian cancer was evaluated in a series of 113 patients. ⋯ The benefit in survival after the procedure of lymph node sampling in early stages of epithelial ovarian carcinoma could probably be explained by the fact that the surgical procedure detects otherwise unrecognized Stage III disease.
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Massive presacral bleeding arising during gynaecological surgery can be sudden, rapid and life-threatening. Further, its control and management can be challenging, since standard measures are frequently ineffective. ⋯ Despite this, it does not appear to be widely known or used in gynaecological surgery. A case is presented in which the technique was used, and the literature on its use is reviewed.