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Mexico City, Mexico

Cruz-Benitez L.,Servicio de Oncologia Quirurgica | Morales-Hernandez E.,Cirugia Oncologica
Gaceta Mexicana de Oncologia | Year: 2014

Introduction: Surgical treatment of breast tumors has undergone several modifications over time, from being an aggressive and mutilating procedure as classical radical mastectomy, to become a surgery in our present increasingly conservative, focused on decreasing the psychological impact that this condition prints to patients. Objective: Introduce through a systematic review in the world medical literature, the development undergone by different surgical techniques for the management of breast tumors over time. Methods: Was carried out through a search in Internet servers such as Medline, Scielo, PubMed, among others, in order to locate medical articles concerning this topic. Conclusions: The treatment of operable breast cancer is no longer a radical surgery, bloody, mutilating, which existed as the only treatment option, into an increasingly conservative surgery, performed in a cosmetically acceptable and which is equivalent to performing mastectomy with respect to recurrence and survival. © 2014 Gaceta Mexicana de Oncología. Publicado por Masson Doyma México S.A. Source

Ortiz-Mendoza C.M.,Servicio de Oncologia Quirurgica
Cirugia y Cirujanos | Year: 2010

Background: Textilomas may mimic a malignant neoplasm and may occur in rare locations. Clinical case: A 73-year-old female presented a groin tumor of 3 years duration after saphenectomy. Physical exam of the right groin area demonstrated an 8-cm oval tumor below the inguinal ligament and above the femoral vessels. An ultrasound and a CT scan showed a mixed cyst. During surgical exploration of the groin, an 8-cm tumor fixed to the femoral vein was extirpated en bloc. Histopathological results reported a textiloma. The patient had an uneventful postoperative evolution. Conclusions: Textilomas may mimic a neoplasm, but their occurrence in the groin is exceptional. Source

Valencia-Cedillo R.,Centro Medico Nacional Siglo XXI | De Anda-Gonzalez J.,Centro Medico Nacional Siglo XXI | Rodriguez-Cuevas S.,Servicio de Oncologia Quirurgica | Aviles A.,Servicio de Patologia | And 2 more authors.
Gaceta Mexicana de Oncologia | Year: 2012

Introduction: The gene of human epidermal growth factor 2 (Her2-neu), has prognostic implications in women with breast cancer. In our current practice, we determine overexpression of Her2-neu by immunohistochemistry (IHC). However, indeterminate results require in situ hybridization (ISH). The fluorescence in situ hybridization (FISH) is the gold standard to verify the amplification of the Her2-neu gene, however, this technique is expensive and difficult to do, so, we use Cromogenic in situ hybridization (CISH) as an alternative method. There are concerns regarding this technique has as good performance as FISH Our main goal was to evaluate the correlation between IHC and CISH for those cases with indeterminate results Material and methods: Paraffin blocks were selected from 114 women with breast cancer at two institutions, Her2-neu determination by IHC and CISH was performed later. The CISH results were based on the count of signals per nucleus and then correlated the results of both methods. Results: Correlation between both methods results was that of 98% , confirming gene amplification in 96% of patients that were positive (3+) with IHC, no amplification of the gene was found in 97% of the negative cases (0, 1+) and 37% of indeterminate cases (2+). Conclusions: The CISH technique proved to be a highly sensitive and specific technique in determining the amplification of the Her2-neu gene, especially in cases with indeterminate immunohistochemistry results (2+). Source

Srur-Rivero N.,Servicio de Oncologia Quirurgica | Cartin-Brenes M.,University of Costa Rica
Breast Cancer: Basic and Clinical Research | Year: 2014

Background: Breast cancer characteristics may vary according to the patient's ethnic group. The goal of this cohort study was to evaluate the characteristics of a group of Costa Rican breast cancer patients and their relationship with survival. Methods: Age, stage, tumor grade, immunohistochemistry, lymphovascular invasion, recurrence, and survival data on 199 Hispanic patients with breast cancer diagnosis, treated between January 2009 and May 2010, were collected from a single institution in San Jose, Costa Rica. The data were statistically analyzed for significance. Results: Median age at diagnosis was 53 years. With a median follow-up of 46.5 months, there was an 88% overall survival rate. Thirty-seven percent of the patients (p < 0.001) were at stages III and IV during diagnosis. The hormone receptor human epidermal receptor negative phenotype (HR-HER2-) (p < 0.001) was present in 17% of the cases. In a multivariate analysis, local (risk ratio, RR: 7.2; confidence interval, CI 95%: 3.8-7.6; p =0.06) and distant recurrence (RR: 14.9; CI 95%: 7.7-28.9; p =0.01) showed the strongest association with the probability of death from the disease. Patients with HR-HER2-phenotype tumors reported more local recurrences (p =0.04), a higher tumor grade (p < 0.01), and lower overall survival than patients with other breast cancer phenotypes (p =0.01). Conclusions: Although this study analyzes a modest number of cases, it is an initial insight into factors that may contribute to differences in breast cancer outcomes among Hispanic women in Costa Rica. The higher proportion of triple negative tumors, advanced stage, and younger median age at diagnosis could contribute to the inferior prognostic described among Hispanic women. There may be a different distribution of tumor subtypes compared to non-Hispanic white women. Further studies are necessary to confirm such findings. © the authors, publisher and licensee libertas academica limited. Source

Background: Persistence or recurrence of carcinoma of the uterine cervix in previously treated patients has a poor prognosis. Rescue surgery is possible if there is central activity and it consists of pelvic exenteration. Objective: To identify risk factors and poor prognosis associated factors that influence survival in patients with gynecologic cancer recurrence in which pelvic excenteration was performed. Methods: Files from patients in which pelvic excenteration was performed in our service between January 2001 to December 2009. Results: Pelvic excenteration was performed in 19 patients with a medium of 53 years old, 8 with persistency and 11 with recurrence. The main factor which influenced overall survival was renal function deterioration and there is an association between time of renal disfunction and survival. There was no difference in survival when persistency and recurrency were compared (p = 0.53). There was no difference in survival depending on initial stage. Medial survival was 21.15 months. Conclusion: Results of the analysis showed that survival is determined by the presence of renal failure and the time of its presentation. Source

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