Andreas Karakatsanis

Clinical signs of fibrosis in small intestinal neuroendocrine tumours.

In patients with small intestinal neuroendocrine tumours (SI‐NETs), serotonin and other cytokines released from tumour cells may induce fibrosis, leading to carcinoid heart disease and abdominal fibrotic reactions. The aim of this study was to assess the prevalence, clinical complications and management of this reaction in the abdomen.

Simplifying Logistics and Avoiding the Unnecessary in Patients With Breast Cancer Undergoing Sentinel Node Biopsy. A Prospective Feasibility Trial of the Preoperative Injection of Super Paramagnetic Iron Oxide Nanoparticles

Purpose: Sentinel node is routinely localized with the intraoperative use of a radioactive tracer, involving challenging logistics. Super paramagnetic iron oxide nanoparticle is a non-radioactive tracer with comparable performance that could allow for preoperative localization, would simplify the procedure, and possibly be of value in axillary mapping before neoadjuvant treatment. The current trial aimed to determine the a priori hypothesis that the injection of super paramagnetic iron oxide nanoparticles in the preoperative period for the localization of the sentinel node is feasible. Methods: This is a prospective feasibility trial, conducted from 9 September 2014 to 22 October 2014 at Uppsala University Hospital. In all, 12 consecutive patients with primary breast cancer planned for resection of the primary and sentinel node biopsy were recruited. Super paramagnetic iron oxide nanoparticles were injected in the preoperative visit in the outpatient clinic. The radioactive tracer (99mTc) and the blue dye were injected perioperatively in standard fashion. A volunteer was injected with super paramagnetic iron oxide nanoparticles to follow the decline in the magnetic signal in the sentinel node over time. The primary outcome was successful sentinel node detection. Results: Super paramagnetic iron oxide nanoparticles’ detection after preoperative injection (3–15 days) was successful in all cases (100%). In the volunteer, axillary signal was presented for 4 weeks. No adverse effects were noted. Conclusion and relevance: Preoperative super paramagnetic iron oxide nanoparticles’ injection is feasible and leads to successful detection of the sentinel node. That may lead to simplified logistics as well as the identification, sampling, and marking of the sentinel node in patients planned for neoadjuvant treatment.

The Breast and Oncoplastic Multidisciplinary Team

The multidisciplinary team is now an essential part of the modern management of breast cancer. The increasing complexity of breast cancer management is due to increased understanding of biological subtypes and progressively more sophisticated surgical, reconstructive and oncological algorithms (e.g. changes to axillary management, expansion of the indications for conservation surgery, expansion of the use and complexity of adjuvant and neoadjuvant therapy protocols). The MDT has a range of potential benefits. Involvement of pathology and radiology permits confirmation of a malignant diagnosis, biological subtyping and accurate staging to facilitate treatment planning. Engagement between surgeons, medical and radiation oncologists permits optimization of oncological outcomes and appropriate use of adjuvant and neoadjuvant regimes. Increasingly, oncoplastic and reconstructive issues are discussed often as part of a formal oncoplastic MDT, to ensure optimal decision-making regarding whether reconstruction is appropriate and what methods might be used and to ensure that reconstructive and oncological considerations are not in conflict. Despite these potential benefits, high-quality data to support the beneficial effects of the MDT are presently lacking, and the cost of the MDT process is considerable. Modern quality assurance standards now recommend that an MDT should be a mandatory component of all breast units.

Optimisation of breast MRI compatibility after sentinel node biopsy with paramagnetic tracers

Optimisation of breast MRI compatibility after sentinel node biopsy with paramagnetic tracers

Abstract P3-01-11: Discoloration after injection of super paramagnetic iron oxide (SPIO) for sentinel node biopsy. A long term qualitative follow-up study

Abstract P3-01-11: Discoloration after injection of super paramagnetic iron oxide (SPIO) for sentinel node biopsy. A long term qualitative follow-up study

Multicentre study evaluating the surgical learning curve for posterior retroperitoneoscopic adrenalectomy: Surgical learning curve for posterior retroperitoneoscopic adrenalectomy

Posterior retroperitoneoscopic adrenalectomy has gained international popularity in the past decade. Despite major advantages, including shorter duration of operation, minimal blood loss and decreased postoperative pain, many surgeons still prefer laparoscopic transperitoneal adrenalectomy. It is likely that the unfamiliar anatomical environment, smaller working space and long learning curve impede implementation. The present study assessed the number of procedures required to fulfil the surgical learning curve for posterior retroperitoneoscopic adrenalectomy.

SentiNot : A way to avoid sentinel node biopsy (SNB) in patients with a preoperative diagnosis of ductal cancer in situ (DCIS)

SentiNot : A way to avoid sentinel node biopsy (SNB) in patients with a preoperative diagnosis of ductal cancer in situ (DCIS)

Superparamagnetic iron oxide nanoparticles as the sole method for sentinel node biopsy detection in patients with breast cancer

Sentinel node biopsy (SNB) using superparamagnetic iron oxide (SPIO) nanoparticles is a novel method in breast cancer. Several studies have verified the non‐inferiority of SPIO compared with the standard use of radioisotope 99mTc with or without blue dye. The aim of the MONOS study presented here was to evaluate the use of SPIO as a sole tracer and the efficacy of tracer injection in the preoperative setting.