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Purpose: Breast-conserving surgery is now accepted as one of the standard therapeutic options for stages I and II breast cancers. Although breast-conserving surgery can help retain a good breast shape, a long marked scar would be a disadvantage. Endoscopic surgery can be performed via a small and remote incision that becomes inconspicuous after surgery. To improve the cosmetic outcome, endoscopic breast-conserving surgery, which can be performed through minimal axillary and periareolar semicircular incisions, was undertaken. Methods and materials: From October 2002 to October 2004, 20 breast cancer patients whose tumor sizes were less than 3 cm and who were clinically node negative without invasion to the skin and pectoralis major muscle underwent endoscopic breast-conserving surgery. First, endoscopic dye-guided sentinel node biopsy was done through a low transverse axillary incision lateral to the pectoralis major muscle. The subpectoral pocket was gently created by Vein Harvest under the view of endoscopic monitor. We made the periareolar semicircular incision to create the skin flap and to resect the tumor-containing quadrant by using Visiport and PowerStar scissors. Frozen-section biopsies were done to rule out tumor invasion to the resection margin. Patient characteristics, tumor characteristics, operation time, and amount of bleedings were all evaluated. Results: The mean age of patients was 45 (range: 25–64). The mean tumor size was 2.2 cm (range: 0.2–4.0 cm). The average operation time of the early 9 cases, except the 3 cases that underwent axillary-node dissection, was 178 minutes, and that of the later 8 cases was 130 minutes (P < 0.001). The mean amount of operative bleeding was 184 ± 130 ml. There were no major complications. Conclusion: Endoscopic breast-conserving surgery is a new technique that can minimize the long operation scar of classic breast-conserving surgery. In properly selected cases, our results showed the maximized cosmetic satisfaction of the breast cancer patients and a shortened operation time after the learning period, promising it could be an alternative to the classic breast-conserving surgery. [ABSTRACT FROM AUTHOR]

Fascin is an actin cross-linking protein, which regulates actin dynamics and filopodia or spike formation, as well as the epithelial-mesenchymal transition, and has been implicated in cell motility. Although, fascin is pivotal in mediating the aggressive behaviour of various types of cancer, its prognostic significance according to tumour stage has yet to be evaluated. Therefore, the present study investigated fascin expression in 194 patients diagnosed with invasive ductal carcinoma of the breast between 2000 and 2005. Fascin protein expression levels were evaluated by immunostaining on a tissue microarray, and the association between fascin expression and various clinicopathological parameters was analysed. Fascin expression was significantly correlated with various clinicopathological parameters, including high histological grade, tumour necrosis, resistance to adjuvant therapy, high expression of p53 and Ki-67 and specific therapeutic markers (oestrogen and progesterone receptor negativity; all P<0.05). Furthermore, univariate and multivariate analyses identified a significant association between fascin expression, and poor disease-free and overall survival, in late-stage breast cancer (all P<0.05). Therefore, fascin may be crucial in predicting aggressive tumour behaviour, particularly in patients with advanced-stage disease that has acquired the properties of migration and invasion. [ABSTRACT FROM AUTHOR]

Introduction. Several studies have shown the feasibility and safety of both transperitoneal and posterior retroperitoneal approaches for single incision laparoscopic adrenalectomy, but none have compared the outcomes according to the left- or right-sided location of the adrenal glands. Materials and Methods. From 2009 to 2013, 89 patients who received LAMP (laparoscopic adrenalectomy through mono port) were analyzed. The surgical outcomes attained using the transperitoneal approach (TPA) and posterior retroperitoneal approach (PRA) were analyzed and compared. Results and Discussion. On the right side, no significant differences were found between the LAMP-TPA and LAMP-PRA groups in terms of patient characteristics and clinicopathological data. However, outcomes differed in which LAMP-PRA group had a statistically significant shorter mean operative time (84.13 ± 41.47 min versus 116.84 ± 33.17 min; P = 0.038), time of first oral intake (1.00 ± 0.00 days versus 1.21 ± 0.42 days; P = 0.042), and length of hospitalization (2.17 ± 0.389 days versus 3.68 ± 1.38 days; P ≤ 0.001), whereas in left-sided adrenalectomies LAMP-TPA had a statistically significant shorter mean operative time (83.85 ± 27.72 min versus 110.95 ± 29.31 min; P = 0.002). Conclusions. We report that LAMP-PRA is more appropriate for right-sided laparoscopic adrenalectomies due to anatomical characteristics and better surgical outcomes. For left-sided laparoscopic adrenalectomies, however, we propose LAMP-TPA as a more suitable method. [ABSTRACT FROM AUTHOR]

The goals of this study were to analyze clinical factors that affect cervical lymph node metastasis (LNM) in papillary thyroid cancer (PTC), and to evaluate the diagnostic accuracy of preoperative ultrasound (US) and computed tomography (CT) of the neck. The study sample included 589 consecutive patients who underwent surgery for PTC. Patient age and sex, number, size, and location of tumors, lymphovascular invasion, and extrathyroidal extension were evaluated as risk factors for central and lateral LNM. Increased risk of lymph node metastasis was found for male patients, <45 years old, with tumor size >1 cm, lymphovascular invasion, and extrathyroidal invasion. Cancers located in the upper neck had a higher relative risk of lateral metastasis than cancers located in the lower neck. Sensitivity of both US and CT imaging was higher for lateral (70-80%) than for central (42-47%) LNM. Specificity of US and CT was high (92-97%) for both central and lateral LNM. Using central lymph node size of greater than 5 mm as an indicator of metastasis, preoperative US had 58.3% sensitivity and 71.4% specificity. Preoperative US and CT imaging are useful for identifying features that indicate a high risk of LNM and for determining appropriate management of PTC. [ABSTRACT FROM AUTHOR]

Background: The excision of breast lesions using an ultrasound-guided vacuum-assisted biopsy device (VABD) is a widely used technique for the diagnosis and treatment of breast disease, but the results of long-term follow-up after VABD excision of benign breast tumours have not been reported. The purpose of this study was to evaluate the results of long-term follow-up after complete excision of benign breast tumours using an ultrasound-guided VABD. Methods: This is a retrospective clinical study. Between January 2001 and December 2004, patients who had undergone VABD excision of benign breast tumours and been followed up by clinical examination and ultrasonography for 2 years or more were included. Results: One hundred eighty-four cases representing 153 patients were studied. The median follow-up period was 33 months (range, 24–67 months). All lesions were histologically benign. The mean size of the lesions was 1.09 ± 0.57 cm (range, 0.3–3.03 cm). Within 2 years after VABD excision, residual lesions were detected in 10% of patients sonographically, but after 2 years or more, residual masses were found in 6.5% of patients. Scar changes also decreased from 36.0% to 15.8% during the period of follow-up. Finally, the benign breast tumours were completely excised without residual masses in 93.5% of the participant patients. Residual masses developed in two fibroadenoma cases (1.08%); one was re-excised and the other was followed serially. Conclusion: Ultrasound-guided VABD excision is a minimally invasive technique for the complete removal of benign breast tumours. The results of this long-term follow-up of VABD excisions are comparable to conventional methods. [ABSTRACT FROM AUTHOR]