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  • 1
    Online Resource
    Online Resource
    285 Utility of Virtual New-Patient Clinics in Women Under 30
    Oxford University Press (OUP) ; 2022
    In:  British Journal of Surgery Vol. 109, No. Supplement_6 ( 2022-08-19)
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. Supplement_6 ( 2022-08-19)
    Abstract: Virtual consultations (VC) in breast surgery have been successfully utilised during the COVID pandemic and have potential to reduce the costs of outpatient clinics as well as increase patient satisfaction. We aimed to assess the utility and safety of VC in new patient clinics in women under 30, which are considered a low-risk subgroup. Method Data was prospectively collected on 118 women aged under 30 who were referred from primary care to the breast clinic between December 2020 and April 2021. Clinicopathological data was collected on referrals, imaging and follow up. Results Median age was 24 years (range 17–30). The commonest presenting symptoms were a lump (69%), breast pain (16%) and nipple symptoms (14%). The VC was performed via video in 63 (53%) patients and via telephone alone in 55 (47%). Nineteen patients (16%) were reassured and discharged directly from VC. Ninety-four patients (80%) underwent an outpatient ultrasound with a sonographer trained in clinical palpation. Twenty-six (27%) ultrasounds showed benign pathology with the remainder being normal. Six biopsies were performed, all of which were benign. Seventeen (14%) patients required a face-to-face appointment with a breast surgeon after ultrasound or biopsy. Ninety-four (79%) patients were discharged after VC + ultrasound alone. No patients required surgery. Conclusions Utilising VC, the majority of new referrals in women under 30 did not require face-to-face appointments. VC have potential to reduce burden on new patient clinics whilst improving patient convenience. Early data suggest a low risk of compromising safety in this subgroup.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znac269.065
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2006309-X
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  • 2
    Online Resource
    Online Resource
    266 Breast Cancer in Women Under 30: A Multidisciplinary Approach in a Unique Cohort
    Oxford University Press (OUP) ; 2022
    In:  British Journal of Surgery Vol. 109, No. Supplement_6 ( 2022-08-19)
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. Supplement_6 ( 2022-08-19)
    Abstract: Breast cancer in younger women is relatively rare, tends to be more aggressive and is associated with unique challenges. We sought to examine our practice in managing cancer in patients under 30. Method A retrospective case-note review was performed on patients under 30 years of age diagnosed with invasive breast through our pathology database since 2007. Clinical and pathological data was collected on patients’ cancers, management and follow up as well family history, genetic testing, and fertility management. Results Forty-five patients were identified. Median age was 28 years (range 20 to 30). Mean tumour size was 30mm (range 4–65mm). Seventeen (38%) of cancers were ER negative, 16 (36%) were HER2 positive. Twenty-three patients (51%) had positive lymph node metastases. SIx patients (13%) had a strong family history and 9 (20%) were BRCA 1 or 2 gene positive. Seven patients (15%) underwent contra-lateral risk-reducing mastectomy. Twenty-5 patients (55%) had no children at diagnosis. Fertility management was discussed with & gt;90% of patients and 12 patients (26%) underwent ovum or embryo preservation. Over a median follow up of 40.5 months (range 4.5 to 128 months), 8 patients (18%) developed local or distant recurrence and 6 patients (13%) died (due to metastasis). Conclusion In our experience, breast cancer patients under 30 had more aggressive cancers with a relatively high rate of axillary metastases at presentation. Young patients with breast cancer face unique management challenges such as fertility, genetic testing and survivorship issues that are best addressed in a multidisciplinary setting.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znac269.063
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2006309-X
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  • 3
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    Effects of Diet and Exercise in Middle Aged Subjects with Impaired Glucose Tolerance
    Bangladesh Academy of Sciences ; 2014
    In:  Bangladesh Journal of Medical Biochemistry Vol. 7, No. 1 ( 2014-04-11), p. 17-26
    Details
    In: Bangladesh Journal of Medical Biochemistry, Bangladesh Academy of Sciences, Vol. 7, No. 1 ( 2014-04-11), p. 17-26
    Abstract: Patients with impaired glucose tolerance (IGT) are now considered as being pre-diabetic, which indicates their relatively high risk for developing diabetes mellitus associated with abnormal metabolic syndrome and cardiovascular diseases. However, dietary modification and physical exercise may play a critical role in this respect. To determine the influence of dietary modification and physical exercise in subjects with impaired glucose tolerance in Bangladesh, thirty three newly detected otherwise healthy subjects with IGT, aged 30-63 years, were randomly selected to participate in a 12 weeks diet and exercise program. Substantial improvement in glucose tolerance was observed at the end of 12 weeks particularly in middle aged subjects (41-50 years). Mean fasting blood glucose and 2 hr post load glucose value were reduced significantly. Glucose tolerance was reverted to normal in 66.7% of the participants, remained unchanged in 26.7% and deteriorated to diabetes in 6.7%. Significant reduction in serum total cholesterol, LDL cholesterol along with mild deterioration in HDL cholesterol and increase in triglyceride values were observed. It was found that the principles of 'prudent diet' in combination with physical exercise are highly effective in improving glucose tolerance, lowering total cholesterol and LDL cholesterol in IGT subjects. DOI: http://dx.doi.org/10.3329/bjmb.v7i1.18575 Bangladesh J Med Biochem 2014; 7(1): 17-26
    Type of Medium: Online Resource
    ISSN: 2408-8331 , 2073-9915
    URL: Article
    DOI: 10.3329/bjmb.v7i1.18575
    Language: Unknown
    Publisher: Bangladesh Academy of Sciences
    Publication Date: 2014
    detail.hit.zdb_id: 2852963-7
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  • 4
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    Online Resource
    Effect of Acrylic Polymers on the Physical Parameters and 〈i〉in vitro〈/i〉 Release Kinetics of Diclofenac Sodium Sustained Release Pellets
    Bangladesh Academy of Sciences ; 1970
    In:  Bangladesh Journal of Scientific and Industrial Research Vol. 42, No. 3 ( 1970-01-01), p. 239-248
    Details
    In: Bangladesh Journal of Scientific and Industrial Research, Bangladesh Academy of Sciences, Vol. 42, No. 3 ( 1970-01-01), p. 239-248
    Abstract: The aim of the present study is to investigate the effect of Ammonio Methacrylate Copolymer Type A (Eudragit RL 30 D) and Ammonio Methacrylate Copolymer Type B (Eudragit RS 30 D) on the release kinetics study of diclofenac sodium form coated pellets. Eudragit RS 30 D and Eudragit RL 30 D were added into the formulation at 5:1 ratio. Different percent of this polymeric combination was loaded on to the drug-loaded pellets. Loss on drying value as well as bulk density of coated pellets increase along with the increase in polymer level. It was found that the cumulative percent release of drug decreased with the increase of polymer load in all cases. From all formulations it was observed that the release of diclofenac sodium in 0.1N HCl media was very low (maximum 2.87 %) at first 2 hours. Better sustaining effect was found from Eudragit RS 30 D and Eudragit RL 30 D combinations. Drug was released linearly along with time throughout the whole dissolution process in phosphate buffer (pH 6.8) and it was also revealed that, in all cases the release of diclofenac sodium followed zero order kinetics. Key words: Diclofenac sodium, Eudragit RL 30 D, Eudragit RS 30 D, Aqueous coating, Physical parameters, Kinetics of drug release Bangladesh J. Sci. Ind. Res. 42(3), 239-248, 2007
    Type of Medium: Online Resource
    ISSN: 2224-7157 , 0304-9809
    URL: Article
    DOI: 10.3329/bjsir.v42i3.662
    Language: Unknown
    Publisher: Bangladesh Academy of Sciences
    Publication Date: 1970
    detail.hit.zdb_id: 2381023-3
    SSG: 11
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  • 5
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    P3-07-42: Lymphovascular Invasion Best Correlates with Presence of Nodal Metastasis in Sentinel Lymph Node Biopsy.
    American Association for Cancer Research (AACR) ; 2011
    In:  Cancer Research Vol. 71, No. 24_Supplement ( 2011-12-15), p. P3-07-42-P3-07-42
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 71, No. 24_Supplement ( 2011-12-15), p. P3-07-42-P3-07-42
    Abstract: Background. Sentinel lymph node biopsy (SLNB) biopsy is routinely practised for axillary staging with 25–30% having positive SLN. Tumour size is the most important parameter taken into consideration in decision making in node negative patients with a size cut off for 4–5cm dependant on different units. Lymphovascular invasion (LVI) and Ki-67 a cell-cycle antigen are known important prognostic markers along with the tumour grade, oestrogen receptor and herceptin receptor status. Aim. To examine whether lymphovascular invasion, Ki-67 or any other factors can be used as a predictor for axillary lymph node involvement and hence prognosis. METHODS. A prospective study of 264 patients with invasive breast cancer undergoing SLN biopsy between January 2009 and December 2010. Histopathology reports were reviewed regarding LVI, Ki-67, grade, oestrogen, Progesterone and Herceptin receptor and SLN status. Stats direct was used to analyse data. Logistic regression was used and p-value calculated. RESULTS. LVI (p value=0.0001) and size(p value=0.0273) were the two most significant factors associated with node positivity. Grade of tumour had a p-value of 0.0825 and Ki67 had a p-value of 0.5217 which were not significant. DISCUSSION. LVI is the factor which best corelates with presence of metastasis in sentinel lymph node. If this information is available at the time of decision making, it should be strongly considered and pathologists should be encouraged to provide the information. In the absence of LVI, size still remains the best predictor of sentinel lymph node metastasis pre-operatively although consideration of other factors, such as the grade is definitely relevant. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-07-42.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/0008-5472.SABCS11-P3-07-42
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 6
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    Online Resource
    Sentinel lymph node biopsy (SLNB) prior to primary chemotherapy (PC) in breast cancer patients.
    American Association for Cancer Research (AACR) ; 2009
    In:  Cancer Research Vol. 69, No. 2_Supplement ( 2009-01-15), p. 5111-
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 69, No. 2_Supplement ( 2009-01-15), p. 5111-
    Abstract: Abstract #5111 Background: Lymph node status is the single most important determinant of prognosis and is used for planning adjuvant therapy. Patient selection and timing of SLNB for PC continue to evolve; SLNB prior to PC may allow more accurate initial staging and prognostication and guide decisions about adjuvant treatment. & #x2028; Methods: 78 patients (pts) who were treated in the Cambridge Breast Unit as part of Neo-tAnGo (a multicentre PC trial). 57 were identified as potentially suitable for SLNB pre-PC (clinically node negative, non-inflammatory tumours 2–5cm in size). 38 had axillary ultrasound, and of these, 18 had sonographically suspicious nodes. 12/18 had confirmed nodal metastasis on core biopsy (CB) and had direct ALND post-PC. The remaining 20 patients had innocent nodes or were CB negative, of whom 19 underwent SLNB. A total of 19 patients in this subgroup did not undergo axillary ultrasound; 16 of these proceeded to ALND post-PC and 3 to SLN biopsy pre-PC according to unit policy at the time. A total of 22 (19 + 3) pts were available for analysis of SLN biopsy pre-PC in terms of time to treatment compared to the remainder of the centre's cohort in the Neo-tAnGo study. 42, (22 SLNB + 20 node positive on CB), were analysed as having axillary pathological staging before PC and compared to the other patient cohort on study. & #x2028; Results: The SLN was successfully identified in all 22 pts using dual localisation techniques with a mean SLN harvest of 2.8 nodes per patient (range 1–10). 6/22 pts (27%) were node positive, and 5 had single SLN involvement (4 macro-; 1 micro-) and one had a macro- and a micrometastasis in 2 different nodes. The mean time from diagnosis to start of PC in the SLN group was 23 days (range 8–43) compared 18 days (range 7–36) for the comparator cohort on study (p=0.02). When all 42 pts with pathological axillary assessment were analysed (including clinically node positive pts with tumours & gt;5cm), there was no significant difference in time from diagnosis to start of PC for pts undergoing CB and/or SLNB (21 days) compared with no axillary assessment (17 days) (wilcoxon test p=0.10). The mean number of nodes removed on completion ALND was 9 (range 4–16). There was no evidence of any viable tumour or fibrosis in any of the non-SLN's (NSLN) examined. Amongst the group of 18 ultrasound/CB positive pts who underwent ALND without SLNB, nodal disease was found in 9 (50%) with evidence of pathological downstaging in 4 (22%). & #x2028; Conclusion: There is potential loss of staging information when SLNB is performed after PC and the clinical significance of a negative SLNB result in this setting is uncertain. A combination of axillary ultrasound (with CB) and SLNB can more accurately stage the axilla without significant overall delays in commencement of PC for clinically node positive and negative pts. Downstaging of disease in NLSN may occur in response to PC with a lower NSLN rate (0%) when compared to primary surgical treatment in smaller tumours (15–25%). Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5111.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/0008-5472.SABCS-5111
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2009
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 7
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    Online Resource
    Value of axillary ultrasound and cytology in assessing nodal status preoperatively.
    American Association for Cancer Research (AACR) ; 2009
    In:  Cancer Research Vol. 69, No. 2_Supplement ( 2009-01-15), p. 1007-
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 69, No. 2_Supplement ( 2009-01-15), p. 1007-
    Abstract: Abstract #1007 Preoperative identification of axillary node involvement in early breast cancer allows correct surgical procedures to be performed and avoids second axillary operations. We compared preoperative axillary assessment using ultrasound ± cytology with the eventual histopathological results to identify the accuracy of preoperative axillary node assessment. & #x2028; Methods: Preoperative axillary ultrasound was used to identify the presence of suspicious or malignant nodes which were then confirmed with cytological assessment to allow management decisions regarding axillary clearance (or sentinel node biopsy (SNB) if nodes appeared negative). & #x2028; Results: Overall 79/365 (21%) early breast cancer patients had suspicious or malignant nodes on ultrasound, of which 78 were confirmed on cytology, thus avoiding an unnecessary SNB operation in these patients. Ultrasound and cytology accurately identified patients with ER negative (P=≤0.001), high grade (P=≤0.001) and large size tumours ≤20mm (P=≤0.001), with involved nodes. Only 11% ER negative compared to 46% ER positive tumours were incorrectly classified (P=0.002). In contrast ER positive, low grade, small tumours were most likely to have a false negative axillary assessment. Specificity of cytological assessment of nodes was 99% and sensitivity 54%. & #x2028; Conclusions: Axillary ultrasound combined with cytological assessment of suspicious nodes accurately identifies majority of women who require axillary clearance. & #x2028; & #x2028; Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1007.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/0008-5472.SABCS-1007
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2009
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 8
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    267 Axillary Recurrence Following Negative Sentinel Lymph Node Biopsy for Symptomatic Invasive Breast Cancer: A Ten-Year Review
    Oxford University Press (OUP) ; 2022
    In:  British Journal of Surgery Vol. 109, No. Supplement_6 ( 2022-08-19)
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. Supplement_6 ( 2022-08-19)
    Abstract: Sentinel node biopsy (SNB) became established as the standard approach (versus axillary clearance) for axillary staging in the 2000s. This was based on studies showing reductions in short-term morbidity. Symptomatic cancers are biologically more aggressive than screen-detected cancers and are more susceptible to late loco-regional recurrence. Few studies have examined long-term axillary recurrence following SNBs in this subgroup. Method A retrospective case-note review was performed on 82 symptomatic breast cancer patients who had a negative SNB between 2009 and 2010. Clinicopathological data was collected on cancers, axillary nodal pathology, recurrence, and survival. Results Median age was 57 years (range 23–87). Mean tumour size was 20mm (range: 5–50). Fourteen cancers (17%) were ER negative, 11 (19.3%) HER2 positive and 30 (36.3%) were grade 3. Sixty-one (74%) patients had breast-conserving surgery and 21 patients (26%) underwent a mastectomy. After a median follow up of 11.8 years, 3 (3.7%) local, 1 (1.2%) axillary and 10 (12.2%) distant recurrences were seen. Twenty patients (25%) died. The median OS was 11.64 years (range: 1.20–12.47) and median DFS was 11.50 years (range: 1.14–12.47). Axillary recurrence rates were comparable to other studies that contained predominantly screening cancers (0.7–1.6%). Conclusion The risk of axillary recurrence and remains low at 10-year follow up after a negative SNB in symptomatic patients. This is comparable to that of follow up studies in mixed (screening and symptomatic) cohorts demonstrating equivalent long-term oncological safety in this biologically more aggressive cohort.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znac269.064
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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