Journal of the American College of Surgeons
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Clinical Trial
Liver Function Assessment Using Technetium-99m-Galactosyl Single Photon Emission CT/CT Fusion Imaging: A Prospective Trial.
The prediction of postoperative liver function remains a largely subjective practice based on CT volumetric analysis. However, future liver volume after a hepatectomy is not the only factor that contributes to postoperative liver function and outcomes. ⋯ Results of this study showed that remnant KGSA provided information that allowed us to predict remnant liver function. This information will be important for surgeons when deciding on a treatment plan for patients with liver diseases. (ClinicalTrials.gov ID: NCT02013895).
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Current treatment for HER-2+ breast cancer includes chemotherapy and targeted HER-2 therapy with trastuzumab and/or pertuzumab. Evidence is lacking on the safety of breast reconstructive operations in these patients. We hypothesized that targeted HER-2 therapy was not associated with post-mastectomy reconstructive outcomes. ⋯ Our study suggests that trastuzumab therapy in conjunction with breast reconstructive operation is not associated with reconstructive complications, and breast reconstruction does not need to be delayed due to the administration of trastuzumab. Future studies are needed to evaluate the impact of pertuzumab on surgical outcomes.
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In the setting where determining extent of residual disease is key for surgical planning after neoadjuvant chemotherapy (NAC), we evaluate the reliability of MRI in predicting pathologic complete response (pCR) of the breast primary and axillary nodes after NAC. ⋯ Radiologic complete response by MRI does not predict pCR with adequate accuracy to replace pathologic evaluation of the breast tumor and axillary nodes.
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Our aim was to determine upgrade rates of pure flat epithelial atypia (FEA) to malignancy and higher-risk lesions and to identify patients with FEA at low risk for upgrade. ⋯ The overall risk of upgrade of FEA to malignancy is low at 2.4%; however, the upgrade rate to a higher-risk lesion is nearly 30%. Surveillance rather than surgical excision of FEA can be a reasonable option for patients without a genetic mutation who opt against chemoprevention.