- Reliability of Breast Ultrasound BI-RADS Final Assessment in Mammographically Negative Patients with Nipple Discharge and Radiologic Predictors of Malignancy. [Journal Article]
- JBJ Breast Cancer 2016; 19(3):308-315
- CONCLUSIONS: The BI-RADS lexicon and final assessment of breast US reliably detect and characterize malignancy in mammographically negative patients with pathologic nipple discharge.
- Granulomatous Mastitis: A Rare Cause of Male Breast Lump. [Journal Article]
- CRCase Rep Oncol 2016 May-Aug; 9(2):516-519
- CONCLUSIONS: Granulomatous mastitis is rare in females and extremely rare in male breast tissue. Since this disease mimics breast cancer in its clinical picture and radiologic findings are usually not conclusive, surgical excision is recommended in all cases.
- Ductal Carcinoma In situ of the Male Breast. [Journal Article]
- BCBreast Care (Basel) 2016; 11(4):288-290
- CONCLUSIONS: Male breast cancer is uncommon and, although there is increasing awareness, it is less studied compared to female breast cancer. With a clinical history of nipple discharge of any kind, further evaluation with imaging should be considered. In males with gynecomastia, it is important to remember that ductal carcinoma in situ, even of high grade, is difficult to detect on mammography and may not be associated with suspicious calcifications.
- Acute myeloid leukemia presenting as galactorrhea. [Journal Article]
- PProc (Bayl Univ Med Cent) 2016; 29(4):395
- Acute myeloid leukemia (AML) presents with symptoms related to pancytopenia (weakness, infections, bleeding diathesis) and organ infiltration with leukemic cells. Galactorrhea is an uncommon manifest...
Acute myeloid leukemia (AML) presents with symptoms related to pancytopenia (weakness, infections, bleeding diathesis) and organ infiltration with leukemic cells. Galactorrhea is an uncommon manifestation of AML. We report a case of AML presenting with galactorrhea.
- Cabergoline or bromocriptine for prolactinoma? [Journal Article]
- MMedwave 2016 Sep 15; 16(Suppl3):e6545
- Cabergoline and bromocriptine are among the most commonly used drugs to treat prolactinoma. Cabergoline is a long-acting dopamine receptor agonist which might offer advantages over bromocriptine. How...
Cabergoline and bromocriptine are among the most commonly used drugs to treat prolactinoma. Cabergoline is a long-acting dopamine receptor agonist which might offer advantages over bromocriptine. However, it is not clear if this translates into clinical benefits. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including 12 studies addressing the question of this article, including five randomized controlled trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded cabergoline is more effective than bromocriptine in resolution of amenorrhea/oligomenorrhea and galactorrhea, it probably increases pregnancy rate, and it is associated to less adverse effects. It is not clear whether cabergoline is also more effective with respect to tumor growth because the certainty of the evidence is very low.
- Time Course of Resolution of Hyperprolactinemia after Transsphenoidal Surgery among Patients Presenting with Pituitary Stalk Compression. [Journal Article]
- WNWorld Neurosurg 2016 Sep 23
- CONCLUSIONS: Transsphenoidal surgery can provide durable normalization of serum prolactin levels and related symptoms due to pituitary stalk compression related lactotroph disinhibition.
- Malignancy Rate, Number Needed to Treat, and Positive Predictive Value for Breast MRI. [Journal Article]
- ASAm Surg 2016; 82(9):815-9
- Breast MRI is being used more frequently for advanced screening for breast cancer. Patients may be at increased risk, or are symptomatic, with nonsuspicious mammograms. There is little data regarding...
Breast MRI is being used more frequently for advanced screening for breast cancer. Patients may be at increased risk, or are symptomatic, with nonsuspicious mammograms. There is little data regarding the likelihood of a recommendation for biopsy, or for detecting a malignancy, in this population. We intended to determine the malignancy rate, number needed to treat, and positive predictive value for patients receiving adjunctive MRI at our institution. A retrospective review of all breast MRIs from 2008 to 2010 was done. Patients with any prior diagnosis of breast cancer, or BRCA+ were excluded. There were 324 patients. Most common reasons for ordering the breast MRI included: abnormal test result 130 (44%), palpable mass 74 (23%), family history 58 (18%), breast pain 47 (15%), and nipple discharge 45 (14%). Breast Imaging-Reporting and Data System score (BIRADS) was 1 or 2 in 36 per cent, 4 or 5 in 18 per cent, 3 in 26 per cent, 0 in 10 per cent, and not given in 9 per cent. Biopsy was recommended in 77 (24%), with biopsy actually performed in 57 (18%). Of the eight cancers identified, four (1.2%) were ductal carcinoma in situ (DCIS) and four (1.2%) were invasive cancer, yielding a true-positive rate of 2.5 per cent. Number needed to treat was 40. Positive predictive value was 14 per cent with a false-positive rate of 86 per cent. In this group of generally higher risk women, typically prescreened with mammography, 1.2 per cent had an invasive cancer, and another 1.2 per cent had DCIS. Those who undergo biopsy are 6.1 times more likely to have benign pathology. The efficacy of adjunctive breast MRI could be improved through refinements in indication, test interpretation, or alternative screening strategies.
- Galactorrhoea of the neck following pectoralis major reconstruction of a pharyngeal defect. [Journal Article]
- ARAnn R Coll Surg Engl 2016 Sep 23; :e1-e2
- We describe a case of postoperative galactorrhea following the use of a pedicled pectoralis major myocutaneous flap for reconstruction of a pharyngolaryngeal defect in a woman with squamous cell carc...
We describe a case of postoperative galactorrhea following the use of a pedicled pectoralis major myocutaneous flap for reconstruction of a pharyngolaryngeal defect in a woman with squamous cell carcinoma. We believe this to be unique in the literature, and an important complication to be reported, due to the similarities in appearance of galactorrhoea and postoperative aerodigestive tract/cutaneous fistula.
- Effect of Adjunctive Aripiprazole on Sexual Dysfunction in Schizophrenia: A Preliminary Open-Label Study. [Journal Article]
- PPharmacopsychiatry 2016 Sep 22
- Introduction: Although adjunctive aripiprazole improves hyperprolactinemia, sufficient evidence for its effects on sexual dysfunction has not been obtained. We assessed the usefulness of adjunctive a...
Introduction: Although adjunctive aripiprazole improves hyperprolactinemia, sufficient evidence for its effects on sexual dysfunction has not been obtained. We assessed the usefulness of adjunctive aripiprazole for schizophrenia with sexual dysfunction. Methods: 22 Japanese schizophrenia patients with antipsychotic-induced hyperprolactinemia and sexual dysfunction were enrolled, and 19 of them completed the study. Aripiprazole was administrated in a flexible titration schedule to participants according to the judgment of each doctor, and patients were followed for 24 weeks. Serum prolactin, Clinical Global Impression Scales-Severity (CGI-S), and Nagoya Sexual Function Questionnaire (NSFQ) were measured at baseline and at 4, 8, 12, and 24 weeks. Results: Prolactin at week 4 and later was significantly lower than that at baseline. Compared to baseline, we observed a significant improvement in total sexual dysfunction as measured by NSFQ at week 8 and later. In males, erectile dysfunction was significantly reduced at week 24. In females, menstrual irregularity and galactorrhea were significantly reduced at week 24. CGI-S did not significantly change. Discussion: Although the small sample size is a limitation in this study, adjunctive aripiprazole may be useful treatment for sexual dysfunction including hyperprolactinemia in schizophrenia.
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- An Adolescent Girl with Giant Fibroadenoma - A Case Report. [Journal Article]
- PPPol Przegl Chir 2016 Sep 1; 88(4):218-20
- Though fibroadenoma is the most common benign tumor of the breast and is more common under the age of 30, giant fibroadenoma is rare representing less than 4% of all fibroadenomas. A 12 years old gir...
Though fibroadenoma is the most common benign tumor of the breast and is more common under the age of 30, giant fibroadenoma is rare representing less than 4% of all fibroadenomas. A 12 years old girl presented with rapidly enlarging well-circumscribed firm, non-tender mass in right breast for 2 months which was painless and with no history of trauma, nipple discharge, fever, anorexia, weight loss or axillary lymphadenopathy. There was no family history of neoplasms. Clinically, the lump was about 12 × 12 cm and not fixed to skin or underlying structures with the absence of nipple retraction or discharge. There was no axillary lymphadenopathy. Fine needle aspiration cytology showed a benign proliferative breast disease. Total excision of mass was done preserving nipple and areola having weight of 535 gm with histopathological features suggestive of giant fibroadenoma. Giant fibroadenoma is a benign breast disease that may mimic rare malignant lesion. So, breast and nipple conserving surgery should always be performed irrespective of size of tumor as in this case.