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Inflammatory Breast Cancer Management

تدبير سرطان الثدي الالتهابي

2058   1   6   0 ( 0 )
 Publication date 2013
and research's language is العربية
 Created by Shamra Editor




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A retrospective study included 25 cases with inflammatory breast cancer. The patients were admitted to AL-Assad University Hospital, Lattakia, Syria (average age 55, and range 49-61 years old). The most common clinical signs and symptoms were: erythema 100%, edema 100%, enlarged axillary nodes 100%, Nipple flattened/inverted 96%, warm Breast 92%, Ridges/thickening of breast 84%, Peau d’orange 88%, painful/tender Breast 88%, and Mass 80%. Mammography findings were: an increase in skin thickness 100%, an increased tissue density in the involved breast 100%, and an asymmetric widening of the sub-cutaneous lymphatic vessels 33.33%. 80% of cases were diagnosed as stage IV. All patients received primary neoadjuvant chemotherapy for three cycles. After that a modified radical breast mastectomy and axillary lymph nodes dissection were performed for all patients. The wound edges were closed primarily after dissecting the skin in 76%, for 4 patients 16% a split-thickness skin grafts were performed, and for 2 patients 8% a Latissimus dorsi pedicled myocutaneous flap was performed.


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Research summary
تتناول الدراسة الاسترجاعية التي أجراها الدكتور علي علوش تدبير سرطان الثدي الالتهابي، وهو أحد أكثر أنواع سرطان الثدي عدوانية. شملت الدراسة 25 مريضة تتراوح أعمارهن بين 49 و61 سنة، بمتوسط عمر 55 سنة، وتمت معالجتهن في مشفى الأسد الجامعي باللاذقية خلال الفترة من 1/1/2005 حتى 2/1/2013. كانت الأعراض السريرية الأكثر شيوعاً هي احمرار جلد الثدي، وذمة، وضخامة العقد اللمفاوية الإبطية، وانكماش الحلمة، وحرارة موضعية في الثدي، وسماكة الجلد، وعلامة قشر البرتقال، وألم في الثدي، وجس كتلة في الثدي. أظهرت الفحوصات الشعاعية زيادة في سماكة الجلد وكثافة نسيج الثدي في الجهة المصابة، وعدم تناظر في الأوعية اللمفاوية تحت الجلد. كانت 80% من الحالات في المرحلة IV. خضعت جميع المريضات للعلاج الكيميائي قبل الجراحة، وتم إجراء استئصال الثدي الجذري المعدل مع تجريف للعقد اللمفاوية الإبطية. تم تقريب حواف الجرح بشكل مباشر لدى 76% من المريضات، بينما احتاجت 16% لسدائل جلدية و8% لسديلة عضلية جلدية. أكدت الدراسة أن سرطان الثدي الالتهابي يتطلب تشخيصاً مبكراً وعلاجاً متعدد الطرق يشمل العلاج الكيميائي والجراحة والعلاج الشعاعي والهرموني.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة جداً في تسليط الضوء على سرطان الثدي الالتهابي، وهو نوع نادر وعدواني من سرطان الثدي. ومع ذلك، يمكن أن تكون هناك بعض النقاط التي تحتاج إلى تحسين. على سبيل المثال، كان من الأفضل تضمين مجموعة مقارنة من المرضى الذين يعانون من أنواع أخرى من سرطان الثدي لتحديد الفروقات بشكل أكثر وضوحاً. كما أن الدراسة لم تتناول بشكل كافٍ تأثير العوامل الوراثية والبيئية على تطور المرض. بالإضافة إلى ذلك، كان من الممكن تقديم معلومات أكثر تفصيلاً حول العلاج المتمم بعد الجراحة ومدى فعاليته في تحسين معدلات البقاء على قيد الحياة.
Questions related to the research
  1. ما هي الأعراض السريرية الأكثر شيوعاً لسرطان الثدي الالتهابي كما وردت في الدراسة؟

    الأعراض السريرية الأكثر شيوعاً هي احمرار جلد الثدي، وذمة، وضخامة العقد اللمفاوية الإبطية، وانكماش الحلمة، وحرارة موضعية في الثدي، وسماكة الجلد، وعلامة قشر البرتقال، وألم في الثدي، وجس كتلة في الثدي.

  2. ما هي نسبة الحالات التي كانت في المرحلة IV من المرض؟

    كانت 80% من الحالات في المرحلة IV.

  3. ما هي الإجراءات الجراحية التي خضعت لها المريضات بعد العلاج الكيميائي؟

    خضعت جميع المريضات لاستئصال الثدي الجذري المعدل مع تجريف للعقد اللمفاوية الإبطية.

  4. ما هي نسبة المريضات اللواتي احتجن لسدائل جلدية لتغطية الجرح بعد الجراحة؟

    احتاجت 16% من المريضات لسدائل جلدية لتغطية الجرح.


References used
HAAGENSEN, C. Diseases of the breast. 2nded, Saunders, Philadelphia, 1971, p. 576–84
LEVINE PHš STEINHORN SC. Inflammatory breast cancer The experience of the Surveillance, Epidemiology, and End Results (SEER) program. Journal of the National Cancer Institute U.S.A.Vol.74,N°.2, 1985,291–7
CHANG Sš PARKER SL. Inflammatory breast carcinoma incidence and survival: the Surveillance, Epidemiology and End Results program of the National Cancer Institute, 1975–1992. Cancer U.S.A.Vol.82,N°12, 1998,2366–72
BELL C. A system of operative surgery. 2nded, Hale and Hosmer ,Hartford, 1814. p. 136
LEE BJšTANNENBAUM NE. Inflammatory carcinoma of the breast: a report of twenty-eight cases from the breast clinic of the Memorial Hospital. Surgery, Gynecology & Obstetrics U.S.A.Vol.39,N°1, 1924,580–95
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