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Aim: The aim of this study is to evaluate benefits of vacuum-assisted excision of benign and high-risk breast lesions, to compare this type of performance with open surgery, to evaluate complications after this performance and persisting changes after vacuum-assisted excision during examination several months after excision. Method: From January 2019 to March 2021 96 vacuum-assisted biopsies or excisions were performed, 27 of them were performed under ultrasound control. In this study histopathological findings were evaluated, number and character of complications immediately after performance and several months after excision were recorded. Results: Of the total 27 patients with ultrasound-guided vacuum-assisted biopsies or excisions it was performed as a primary type of biopsy in 7 patients. In the cases of the rest 20 patients it was indicated as vacuumassisted excision after previous core biopsy. For instance, patients with symptomatical fibroadenomas or patients with high-risk breast lesion after previosus core biopsy. In 2 cases invasive breast cancer were founded and one of these patients underwent surgical resection and biopsy of sentinel node. In the second case with carcinoma surgical performace was contraindicated due to comorbidities. In the rest of 25 cases following surgical treatment was not required. Only in 2 cases, larger hematomas were recorded. Conclusion: Ultrasound-guided vacuumassisted excision is a full-fledged replacement of open surgery exstirpaction. Due to its indisputable advantages it should be recommended to excision of symptomatic benign and high risk breast lesions. [ABSTRACT FROM AUTHOR]

Introduction: Axillary lymph node dissection (ALND) is clearly recommended only for 3 or more positive sentinel lymph nodes today. It is not indicated for a negative sentinel lymph nodes and presence of only isolated tumor cells. The benefit of ALND is further investigated in patients with less than 3 positive sentinel nodes and/or with micrometastatic involment only. Aim: To assess the indication of the ALND when the micrometastatic involvement of sentinel node of breast cancer is detected. Methods: Biopsy of sentinel lymph nodes with periareolar application of radiopharmaceutical Sentiscint. 265 patients, 82 of them with positive sentinel lymph nodes, 17 with micrometastatic involvement only, 4 with the combination of micrometastatic and macrometastatic involvement in two different sentinel lymph nodes. The ALND was performed in 7 patients with only micrometastatic involvement and in all 4 patients with a combination of micrometastatic and macrometastatic sentinel lymph node involvement. Patients were then monitored for 41 months in average. Results: At least two sentinel lymph nodes were removed in all patients. Only negative lymph nodes were found in axilla after ALND in 7 patients with isolated micrometastatic involvement of SLN and at least one other negative node. No axillary recurrence has been detected during the follow--up period in the remaining 10 patients. Metastatic axillary lymph nodes were found after ALND at half of the patients with a combination of micrometastatic and macrometastatic involvement of various SLN. Conclusion: It is not possible to predict the axillary lymph node status when only one sentinel lymph node with the micrometastatic involvement is removed and to stop ALND. But if we find at least one other negative lymph node next to isolated micrometastatic involvement of SLN, the risk of axillary lymph node metastases is small and we do not have to indicate ALND. [ABSTRACT FROM AUTHOR]

Aim: Sentinel lymph node (SLN) dissection replaces regional lymphadenectomy in early stages of many tumors. The objective of our study was to evaluate if the SLN dissection can improve staging of prostate cancer, define the regions of primary lymphatic drainage and correlate the staging accuracy of various templates of pelvic lymph node dissection (PLND). Material and methods: Fifty patients with estimated risk of lymphad-enopathy above 5%, based on Briganti nomo-gram, were included in the study. On the day of surgery Tc-99m-labeled nanocolloid was injected into prostate and then the planar lymphoscintigraphy and single-photon emission computer tomography (SPECT) fused with CT images were performed to detect SLN. Patients then underwent SLN dissection and backup PLND. Results: We successfully detected the SLN in 96% of the patients. A total of 186 SLNs were localized by gamaprobe in course of the operation (mean value, 3,7 per patient). Lymph node (LN) metastases were found in 17 (34%) patients. Sensitivity of the procedure was 94.1% and it diagnosed additional micrometastases in 9/17 (53%) patients. Only 35.5% of primary LNs were found in obturator region. The extended PLND re-moveD 94.6% of primary LNs. SLN was identified in presacral and common iliac regions in only 3.2% and 2.2% respectively. Conclusion: SLN dissection shown high sensitivity in identifying LN metastases. The procedure improves staging by detecting higher number of micrometastases and allows to guide the dissection in presacral and internal iliac regions. Lymphatic mapping showed that extended PLND covers 95% of SLNs. PLND limited to obturator region is inadequate procedure as it removes only one third of SLNs. [ABSTRACT FROM AUTHOR]

Review describing actual possibilities in diagnosis and treatment of cervical cancer stage IB1 in group of patients without wishing fertility preservation. Author describes diagnostic and surgical steps needed for surgical approach individualization. There is actual surgical approach classification and sentinel node identification technology and practical application in modern treatment describing in review. [ABSTRACT FROM AUTHOR]