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You searched for:"Henrique Benedito Brenelli"
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Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(4):221-226
DOI 10.1590/S0100-72032002000400002
Purpose: to evaluate the relationdhip between preservation of the intercostobrachial nerve and pain sensitivity of the arm, total time of the surgery, and number of dissected nodes in patients submitted to axillary lymphadenectomy due to breast cancer. Methods: an intervention, prospective, randomized and double-blind study was performed on 85 patients assisted at the State University of Campinas, Brazil, from January 1999 to July 2000. The patients were divided into two groups, according to the intention of preserving or not the intercostobrachial nerve. The surgeries were performed by the same researchers, utilizing the same technique. The postoperative evaluations were performed within 2 days, 40 days and after 3 months. The pain sensitivity of the arm was evaluated through a specific questionnaire (subjective evaluation) and through a neurological physical examination (objective evaluation). Results: the surgical technique was applied to all patients and the preservation of the intercostobrachial nerve was related to a significant decrease in the alterations of pain sensitivity of the arm, both by the subjective and objective evaluations. After three months, in the subjective evaluation, 61% of the patients were asymptomatic in the intercostobrachial nerve preservation group and 28.6% in the nerve section group (p<0.01). By the objective evaluation, 53.7% of the patients presented normal neurological examination in the intercostobrachial nerve preservation group and 16.7% in the nerve section group (p<0.01). No significant difference was observed regarding total time of surgery (p=0.76) and number of dissected nodes between the two evaluated groups (p=0.59). Conclusions: these data show that the preservation of the intercostobrachial nerve is feasible and leads to a significant decrease in the alterations of pain sensitivity of the arm, without interfering in the total time of surgery and the number of dissected nodes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(4):221-226
DOI 10.1590/S0100-72032002000400002
Purpose: to evaluate the relationdhip between preservation of the intercostobrachial nerve and pain sensitivity of the arm, total time of the surgery, and number of dissected nodes in patients submitted to axillary lymphadenectomy due to breast cancer. Methods: an intervention, prospective, randomized and double-blind study was performed on 85 patients assisted at the State University of Campinas, Brazil, from January 1999 to July 2000. The patients were divided into two groups, according to the intention of preserving or not the intercostobrachial nerve. The surgeries were performed by the same researchers, utilizing the same technique. The postoperative evaluations were performed within 2 days, 40 days and after 3 months. The pain sensitivity of the arm was evaluated through a specific questionnaire (subjective evaluation) and through a neurological physical examination (objective evaluation). Results: the surgical technique was applied to all patients and the preservation of the intercostobrachial nerve was related to a significant decrease in the alterations of pain sensitivity of the arm, both by the subjective and objective evaluations. After three months, in the subjective evaluation, 61% of the patients were asymptomatic in the intercostobrachial nerve preservation group and 28.6% in the nerve section group (p<0.01). By the objective evaluation, 53.7% of the patients presented normal neurological examination in the intercostobrachial nerve preservation group and 16.7% in the nerve section group (p<0.01). No significant difference was observed regarding total time of surgery (p=0.76) and number of dissected nodes between the two evaluated groups (p=0.59). Conclusions: these data show that the preservation of the intercostobrachial nerve is feasible and leads to a significant decrease in the alterations of pain sensitivity of the arm, without interfering in the total time of surgery and the number of dissected nodes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):303-308
DOI 10.1590/S0100-72031998000600002
Objective: to compare mammographic density changes, case by case, according to image digitization in three consecutive evaluations of users or nonusers of hormonal replacement therapy (HRT). Methods: 59 postmenopausal women were evaluated, 43 being users of cyclic or continuous estro-progestin hormonal replacement therapy, and 16 nonusers. The criteria of inclusion were: amenorrhea for at least 12 months, a normal mammographic examination at the beginning of the HRT (users) or the clinical follow-up without HRT (nonusers), at two incidences (mediolateral and craniocaudal). The following variables were used for the evaluation of mammary density: initial change - the difference between the first mammography after HRT performed in 12 ± 3 months and the mammography performed before HRT-and final change - the difference between the second mammography after HRT performed in 24 ± 3 months and the mammography performed before HRT. Wilcoxon and c² tests were used in order to evaluate the differences in mammographic density changes. Results: more than half (56.3%) of the women, HRT users with initial increase in mammographic density remained with the increase after the final evaluation. This finding was not significant (p=0.617). In the same group, the initial nonincrease was significantly associated with the final nonincrease (p=0.017). Among the nonusers, all breasts that were not totally fat at the initial evaluation presented a mammographic density decrease at the final evaluation. Conclusions: the majority of HRT users presenting mammographic density increase at the first evaluation, after approximately one year of use, remained with the increase at a second evaluation. After some time, the nonusers tended to present a significant mammographic density decrease (p=0.003).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):303-308
DOI 10.1590/S0100-72031998000600002
Objective: to compare mammographic density changes, case by case, according to image digitization in three consecutive evaluations of users or nonusers of hormonal replacement therapy (HRT). Methods: 59 postmenopausal women were evaluated, 43 being users of cyclic or continuous estro-progestin hormonal replacement therapy, and 16 nonusers. The criteria of inclusion were: amenorrhea for at least 12 months, a normal mammographic examination at the beginning of the HRT (users) or the clinical follow-up without HRT (nonusers), at two incidences (mediolateral and craniocaudal). The following variables were used for the evaluation of mammary density: initial change - the difference between the first mammography after HRT performed in 12 ± 3 months and the mammography performed before HRT-and final change - the difference between the second mammography after HRT performed in 24 ± 3 months and the mammography performed before HRT. Wilcoxon and c² tests were used in order to evaluate the differences in mammographic density changes. Results: more than half (56.3%) of the women, HRT users with initial increase in mammographic density remained with the increase after the final evaluation. This finding was not significant (p=0.617). In the same group, the initial nonincrease was significantly associated with the final nonincrease (p=0.017). Among the nonusers, all breasts that were not totally fat at the initial evaluation presented a mammographic density decrease at the final evaluation. Conclusions: the majority of HRT users presenting mammographic density increase at the first evaluation, after approximately one year of use, remained with the increase at a second evaluation. After some time, the nonusers tended to present a significant mammographic density decrease (p=0.003).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):483-499
DOI 10.1590/S0100-72032013001100002
PURPOSE: To explore the relationship between morphological characteristics and histologic localization of metastasis within sentinel lymph nodes (SLN) and axillary spread in women with breast cancer. METHODS: We selected 119 patients with positive SLN submitted to complete axillary lymph node dissection from July 2002 to March 2007. We retrieved the age of patients and the primary tumor size. In the primary tumor, we evaluated histologic and nuclear grade, and peritumoral vascular invasion (PVI). In SLNs we evaluated the size of metastasis, their localization in the lymph node, number of foci, number of involved lymph nodes, and extranodal extension. RESULTS: Fifty-one (42.8%) patients had confirmed additional metastasis in non-sentinel lymph nodes (NLSN). High histologic grade, PVI, intraparenchymatous metastasis, extranodal neoplastic extension and size of metastasis were associated with positive NLSN. SLN metastasis affecting the capsule were associated to low risk incidence of additional metastasis. After multivariate analysis, PVI and metastasis size in the SLN remained as the most important risk factors for additional metastasis. CONCLUSIONS:The risk of additional involvement of NSLN is higher in patients with PVI and it increases progressively according the histologic localization in the lymph node, from capsule, where the afferent lymphatic channel arrives, to the opposite side of capsule promoting the extranodal extension. Size of metastasis greater than 6.0 mm presents higher risk of additional lymph node metastasis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):483-499
DOI 10.1590/S0100-72032013001100002
PURPOSE: To explore the relationship between morphological characteristics and histologic localization of metastasis within sentinel lymph nodes (SLN) and axillary spread in women with breast cancer. METHODS: We selected 119 patients with positive SLN submitted to complete axillary lymph node dissection from July 2002 to March 2007. We retrieved the age of patients and the primary tumor size. In the primary tumor, we evaluated histologic and nuclear grade, and peritumoral vascular invasion (PVI). In SLNs we evaluated the size of metastasis, their localization in the lymph node, number of foci, number of involved lymph nodes, and extranodal extension. RESULTS: Fifty-one (42.8%) patients had confirmed additional metastasis in non-sentinel lymph nodes (NLSN). High histologic grade, PVI, intraparenchymatous metastasis, extranodal neoplastic extension and size of metastasis were associated with positive NLSN. SLN metastasis affecting the capsule were associated to low risk incidence of additional metastasis. After multivariate analysis, PVI and metastasis size in the SLN remained as the most important risk factors for additional metastasis. CONCLUSIONS:The risk of additional involvement of NSLN is higher in patients with PVI and it increases progressively according the histologic localization in the lymph node, from capsule, where the afferent lymphatic channel arrives, to the opposite side of capsule promoting the extranodal extension. Size of metastasis greater than 6.0 mm presents higher risk of additional lymph node metastasis.
