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Article ; Online: New techniques versus standard mapping for sentinel lymph node biopsy in breast cancer: a systematic review and meta-analysis.

Rocco, Nicola / Velotti, Nunzio / Pontillo, Martina / Vitiello, Antonio / Berardi, Giovanna / Accurso, Antonello / Masone, Stefania / Musella, Mario

Updates in surgery

2023 Volume 75, Issue 6, Page(s) 1699–1710

Abstract: New tracers for sentinel lymph node biopsy (SLNB), as indocyanine green (ICG), superparamagnetic iron oxide (SPIO) and micro bubbles, have been recently introduced in clinical practice showing promising but variable results. We reviewed the available ... ...

Abstract	New tracers for sentinel lymph node biopsy (SLNB), as indocyanine green (ICG), superparamagnetic iron oxide (SPIO) and micro bubbles, have been recently introduced in clinical practice showing promising but variable results. We reviewed the available evidence comparing these new techniques with the standard tracers to evaluate their safety. To identify all available studies, a systematic search was performed in all electronic databases. Data regarding sample size, mean number of SLN harvested for patient, number of metastatic SLN and SLN identification rate of all studies were extracted. No significant differences were found in terms of SLNs identification rates between SPIO, RI and BD but with a higher identification rate with the use of ICG. No significant differences were also found for the number of metastatic lymph nodes identified between SPIO, RI and BD and the mean number of SLNs identified between SPIO and ICG versus conventional tracers. A statistically significant differences in favor of ICG was reported for the comparison between ICG and conventional tracers for the number of metastatic lymph nodes identified. Our meta-analysis demonstrates that the use of both ICG and SPIO for the pre-operative mapping of sentinel lymph nodes in breast cancer treatment is adequately effective.
MeSH term(s)	Humans ; Female ; Sentinel Lymph Node Biopsy/methods ; Breast Neoplasms/surgery ; Breast Neoplasms/pathology ; Coloring Agents ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node/pathology ; Indocyanine Green ; Lymph Nodes/pathology
Chemical Substances	Coloring Agents ; ferric oxide (1K09F3G675) ; Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2023-06-16
Publishing country	Italy
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-023-01560-1
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Article ; Online: Reply: Innovative Management of Implant Infection and Exposure in ADM/Implant-Based Breast Reconstruction with Negative Pressure Wound Therapy.

Accurso, Antonello / Rocco, Nicola / Mattera, Edi / D'Andrea, Francesco

Aesthetic plastic surgery

2017 Volume 41, Issue 5, Page(s) 1239–1240

MeSH term(s)	Acellular Dermis ; Breast Implantation ; Breast Implants ; Breast Neoplasms/surgery ; Mammaplasty ; Negative-Pressure Wound Therapy
Language	English
Publishing date	2017-03-23
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	532791-x
ISSN	1432-5241 ; 0364-216X
ISSN (online)	1432-5241
ISSN	0364-216X
DOI	10.1007/s00266-017-0845-8
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Zs.A 1296: Show issues

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Article ; Online: Telemetry Monitor Watchers Reduce Bedside Nurses' Exposure to Alarms by Intercepting a High Number of Nonactionable Alarms.

Palchaudhuri, Sonali / Chen, Stephanie / Clayton, Elaine / Accurso, Anthony / Zakaria, Sammy

Journal of hospital medicine

2017 Volume 12, Issue 6, Page(s) 447–449

Abstract: Cardiac telemetry, designed to monitor hospitalized patients with active cardiac conditions, is highly utilized outside the intensive care unit but is also resource-intensive and produces many nonactionable alarms. In a hospital setting in which ... ...

Abstract	Cardiac telemetry, designed to monitor hospitalized patients with active cardiac conditions, is highly utilized outside the intensive care unit but is also resource-intensive and produces many nonactionable alarms. In a hospital setting in which dedicated monitor watchers are set up to be the first responders to system-generated alerts, we conducted a retrospective study of the alerts produced over a continuous 2-month period to evaluate how many were intercepted before nurse notification for being nonactionable, and how many resulted in code team activations. Over the 2-month period, the system generated 20,775 alerts (5.1/patient-day, on average), of which 87% were intercepted by monitor watchers. None of the alerts for asystole, ventricular fibrillation, or ventricular tachycardia resulted in a code team activation. Our results highlight the high burden of alerts, the large majority of which are nonactionable, as well as the role of monitor watchers in decreasing the alarm burden on nurses. Measures are needed to decrease telemetry-related alerts in order to reduce alarm-related harms, such as alarm fatigue. Journal of Hospital Medicine 2017;12:447-449.
MeSH term(s)	Academic Medical Centers/methods ; Academic Medical Centers/standards ; Arrhythmias, Cardiac/diagnosis ; Arrhythmias, Cardiac/physiopathology ; Clinical Alarms/standards ; Humans ; Monitoring, Physiologic/methods ; Monitoring, Physiologic/standards ; Nurses/standards ; Patient Admission/standards ; Retrospective Studies ; Telemetry/methods ; Telemetry/standards
Language	English
Publishing date	2017-06-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2233783-0
ISSN	1553-5606 ; 1553-5592
ISSN (online)	1553-5606
ISSN	1553-5592
DOI	10.12788/jhm.2754
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Zs.A 6276: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: The axillary flap in oncoplastic resection of breast cancers located in the upper-outer quadrants

Bordoni, D. / Cadenelli, P. / Ornelli, M. / Falco, G. / Accurso, A. / Gloria, A. / Maietta, S. / Rocco, N. / Magalotti, C.

A new surgical technique

2019

Abstract: Art. 21, 7 S. ... Background: The combination of breast conserving surgery (BCS) with plastic surgery techniques has provided a useful surgical tool matching the radicality of the oncological excision with the preservation of breast cosmesis. Even though ... ...

Abstract	Art. 21, 7 S. Background: The combination of breast conserving surgery (BCS) with plastic surgery techniques has provided a useful surgical tool matching the radicality of the oncological excision with the preservation of breast cosmesis. Even though BCS represents a good option for surgical treatment of tumors located in these quadrants, wide excisions often necessitate breast reshaping in order to avoid nipple areola complex (NAC) displacement and skin retraction. We present a new surgical technique to repair upper-outer quadrants' defects following breast cancer excision using dermo-glandular flaps and an axillary adipo-fascial flap. Methods: During the period from January 2014 to December 2015, 168 patients with an upper-outer quadrant's breast cancer have been treated in our Department. 83 women have been treated with the described oncoplastic technique and immediate contra-lateral symmetrisation and 85 women underwent standard BCS. We present surgical, oncological and cosmetic outcomes comparing our results with standard BCS. Results: At a mean follow-up of 27 months loco-regional recurrences in the two groups were comparable. Short-term complication rates were comparable between the two groups. Re-intervention rates for positive margins were significantly higher in the standard BCS group. The overall satisfaction with cosmetic outcome both assessed by the patient and the surgeon was significantly higher in the oncoplastic group. Conclusions: The proposed oncoplastic technique represents a safe and effective solution for reshaping that follows upper-outer breast cancer wide excision, achieving comparable complication rates, lower re-intervention rates for positive margins and better cosmetic results when compared with standard BCS. 18
Keywords	617
Subject code	616
Language	English
Publishing country	de
Document type	Article ; Online
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Article ; Online: Usefulness of ultrasound-guided fine-needle aspiration cytology in the diagnosis of non-palpable small thyroid nodules: our growing experience.

Accurso, A / Rocco, N / Palumbo, A / Feleppa, C

Journal of endocrinological investigation

2009 Volume 32, Issue 2, Page(s) 156–159

Abstract: Aims and background: Contradictory approaches have been suggested for the management of non-palpable thyroid nodules. The aim of our study is to evaluate indications and limits of ultrasound-guided fine-needle aspiration cytology (US-FNAC) in the ... ...

Abstract	Aims and background: Contradictory approaches have been suggested for the management of non-palpable thyroid nodules. The aim of our study is to evaluate indications and limits of ultrasound-guided fine-needle aspiration cytology (US-FNAC) in the management of non-palpable infracentimetric thyroid nodules. Methods and study design: From September 2003 to June 2007 we studied 1043 patients with non-palpable thyroid nodules. We divided our series into three groups according to the diameter of the lesion in order to verify the effectiveness of US-FNAC for lesions <1 cm. Results: We assessed the cases with satisfactory and unsatisfactory results in the 3 groups into which the sample was divided. Our statistical analysis using the z-test showed there was no significant (p=0.05) difference in the percentage distribution of the unsatisfactory results in the 3 groups. Conclusions: FNAC appears to be a useful diagnostic tool also for nodules <1 cm because the percentage of unsatisfactory results is not related to the size of the nodule.
MeSH term(s)	Biopsy, Fine-Needle/methods ; Cytological Techniques/methods ; Female ; Humans ; Male ; Sensitivity and Specificity ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Nodule/diagnostic imaging ; Treatment Outcome ; Ultrasonography
Language	English
Publishing date	2009-05-01
Publishing country	Italy
Document type	Evaluation Study ; Journal Article
ZDB-ID	432272-1
ISSN	1720-8386 ; 0391-4097 ; 1121-1369
ISSN (online)	1720-8386
ISSN	0391-4097 ; 1121-1369
DOI	10.1007/BF03345706
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Zs.A 1480: Show issues

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Article ; Online: The axillary flap in oncoplastic resection of breast cancers located in the upper-outer quadrants: a new surgical technique.

Bordoni, Daniele / Cadenelli, Pierfrancesco / Ornelli, Matteo / Falco, Giuseppe / Accurso, Antonello / Gloria, Antonio / Maietta, Saverio / Rocco, Nicola / Magalotti, Cesare

BMC surgery

2019 Volume 18, Issue Suppl 1, Page(s) 21

Abstract: Background: The combination of breast conserving surgery (BCS) with plastic surgery techniques has provided a useful surgical tool matching the radicality of the oncological excision with the preservation of breast cosmesis. Even though BCS represents a ...

Abstract	Background: The combination of breast conserving surgery (BCS) with plastic surgery techniques has provided a useful surgical tool matching the radicality of the oncological excision with the preservation of breast cosmesis. Even though BCS represents a good option for surgical treatment of tumors located in these quadrants, wide excisions often necessitate breast reshaping in order to avoid nipple areola complex (NAC) displacement and skin retraction. We present a new surgical technique to repair upper-outer quadrants' defects following breast cancer excision using dermo-glandular flaps and an axillary adipo-fascial flap. Methods: During the period from January 2014 to December 2015, 168 patients with an upper-outer quadrant's breast cancer have been treated in our Department. 83 women have been treated with the described oncoplastic technique and immediate contra-lateral symmetrisation and 85 women underwent standard BCS. We present surgical, oncological and cosmetic outcomes comparing our results with standard BCS. Results: At a mean follow-up of 27 months loco-regional recurrences in the two groups were comparable. Short-term complication rates were comparable between the two groups. Re-intervention rates for positive margins were significantly higher in the standard BCS group. The overall satisfaction with cosmetic outcome both assessed by the patient and the surgeon was significantly higher in the oncoplastic group. Conclusions: The proposed oncoplastic technique represents a safe and effective solution for reshaping that follows upper-outer breast cancer wide excision, achieving comparable complication rates, lower re-intervention rates for positive margins and better cosmetic results when compared with standard BCS.
MeSH term(s)	Adult ; Aged ; Axilla ; Breast Neoplasms/surgery ; Female ; Humans ; Mammaplasty/methods ; Margins of Excision ; Mastectomy, Segmental/methods ; Middle Aged ; Neoplasm Recurrence, Local/surgery ; Retrospective Studies ; Surgical Flaps
Language	English
Publishing date	2019-04-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-018-0467-3
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Article: Mitochondrial Flexibility of Breast Cancers: A Growth Advantage and a Therapeutic Opportunity.

Avagliano, Angelica / Ruocco, Maria Rosaria / Aliotta, Federica / Belviso, Immacolata / Accurso, Antonello / Masone, Stefania / Montagnani, Stefania / Arcucci, Alessandro

Cells

2019 Volume 8, Issue 5

Abstract: Breast cancers are very heterogeneous tissues with several cell types and metabolic pathways together sustaining the initiation and progression of disease and contributing to evasion from cancer therapies. Furthermore, breast cancer cells have an ... ...

Abstract	Breast cancers are very heterogeneous tissues with several cell types and metabolic pathways together sustaining the initiation and progression of disease and contributing to evasion from cancer therapies. Furthermore, breast cancer cells have an impressive metabolic plasticity that is regulated by the heterogeneous tumour microenvironment through bidirectional interactions. The structure and accessibility of nutrients within this unstable microenvironment influence the metabolism of cancer cells that shift between glycolysis and mitochondrial oxidative phosphorylation (OXPHOS) to produce adenosine triphosphate (ATP). In this scenario, the mitochondrial energetic pathways of cancer cells can be reprogrammed to modulate breast cancer's progression and aggressiveness. Moreover, mitochondrial alterations can lead to crosstalk between the mitochondria and the nucleus, and subsequently affect cancer tissue properties. This article reviewed the metabolic plasticity of breast cancer cells, focussing mainly on breast cancer mitochondrial metabolic reprogramming and the mitochondrial alterations influencing nuclear pathways. Finally, the therapeutic strategies targeting molecules and pathways regulating cancer mitochondrial alterations are highlighted.
MeSH term(s)	Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Breast Neoplasms/therapy ; Female ; Humans ; Mitochondria/metabolism ; Models, Biological
Language	English
Publishing date	2019-04-30
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2661518-6
ISSN	2073-4409
ISSN	2073-4409
DOI	10.3390/cells8050401
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Article: Influence of Fibroblasts on Mammary Gland Development, Breast Cancer Microenvironment Remodeling, and Cancer Cell Dissemination.

Avagliano, Angelica / Fiume, Giuseppe / Ruocco, Maria Rosaria / Martucci, Nunzia / Vecchio, Eleonora / Insabato, Luigi / Russo, Daniela / Accurso, Antonello / Masone, Stefania / Montagnani, Stefania / Arcucci, Alessandro

Cancers

2020 Volume 12, Issue 6

Abstract: The stromal microenvironment regulates mammary gland development and tumorigenesis. In normal mammary glands, the stromal microenvironment encompasses the ducts and contains fibroblasts, the main regulators of branching morphogenesis. Understanding the ... ...

Abstract	The stromal microenvironment regulates mammary gland development and tumorigenesis. In normal mammary glands, the stromal microenvironment encompasses the ducts and contains fibroblasts, the main regulators of branching morphogenesis. Understanding the way fibroblast signaling pathways regulate mammary gland development may offer insights into the mechanisms of breast cancer (BC) biology. In fact, the unregulated mammary fibroblast signaling pathways, associated with alterations in extracellular matrix (ECM) remodeling and branching morphogenesis, drive breast cancer microenvironment (BCM) remodeling and cancer growth. The BCM comprises a very heterogeneous tissue containing non-cancer stromal cells, namely, breast cancer-associated fibroblasts (BCAFs), which represent most of the tumor mass. Moreover, the different components of the BCM highly interact with cancer cells, thereby generating a tightly intertwined network. In particular, BC cells activate recruited normal fibroblasts in BCAFs, which, in turn, promote BCM remodeling and metastasis. Thus, comparing the roles of normal fibroblasts and BCAFs in the physiological and metastatic processes, could provide a deeper understanding of the signaling pathways regulating BC dissemination. Here, we review the latest literature describing the structure of the mammary gland and the BCM and summarize the influence of epithelial-mesenchymal transition (EpMT) and autophagy in BC dissemination. Finally, we discuss the roles of fibroblasts and BCAFs in mammary gland development and BCM remodeling, respectively.
Language	English
Publishing date	2020-06-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers12061697
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Article ; Online: Breast implant associated anaplastic large cell lymphoma (BIA-ALCL): a challenging cytological diagnosis with hybrid PET/MRI staging and follow-up.

Verde, Francesco / Vigliar, Elena / Romeo, Valeria / Campanino, Maria Raffaela / Accurso, Antonello / Canta, Luigi / Garbino, Nunzia / Basso, Luca / Cavaliere, Carlo / Nicolai, Emanuele / Imbriaco, Massimo

Breast cancer (Tokyo, Japan)

2020 Volume 28, Issue 2, Page(s) 527–532

Abstract: We report a case of a 55-year-old woman with left breast cosmetic augmentation performed 5 years earlier, showing at ultrasound a left small amount of peri-implant effusion suspicious for an anaplastic large cell lymphoma localization. The final ... ...

Abstract	We report a case of a 55-year-old woman with left breast cosmetic augmentation performed 5 years earlier, showing at ultrasound a left small amount of peri-implant effusion suspicious for an anaplastic large cell lymphoma localization. The final diagnosis was obtained by cytology using a small amount of fluid (6 ml). Subsequently, hybrid 18F-FDG PET/MRI was used for pre-operative staging and follow-up. An appropriate management of BIA-ALCL could be obtained even in cases of a small amount of peri-implant effusion, using a comprehensive approach of clinical and imaging evaluation, including PET/MRI as useful and innovative staging imaging technique.
MeSH term(s)	Breast Implants ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/pathology ; Cytodiagnosis/methods ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Lymphoma, Large-Cell, Anaplastic/diagnostic imaging ; Lymphoma, Large-Cell, Anaplastic/pathology ; Magnetic Resonance Imaging/methods ; Mammaplasty/methods ; Middle Aged ; Positron Emission Tomography Computed Tomography/methods ; Radiopharmaceuticals ; Ultrasonography, Mammary/methods
Chemical Substances	Radiopharmaceuticals ; Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2020-11-01
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	2052429-8
ISSN	1880-4233 ; 1340-6868
ISSN (online)	1880-4233
ISSN	1340-6868
DOI	10.1007/s12282-020-01178-w
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Zs.A 5536: Show issues

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Article ; Online: Tumor segmentation analysis at different post-contrast time points: A possible source of variability of quantitative DCE-MRI parameters in locally advanced breast cancer.

Romeo, Valeria / Cavaliere, Carlo / Imbriaco, Massimo / Verde, Francesco / Petretta, Mario / Franzese, Monica / Stanzione, Arnaldo / Cuocolo, Renato / Aiello, Marco / Basso, Luca / Amitrano, Michele / Lauria, Rossella / Accurso, Antonello / Brunetti, Arturo / Salvatore, Marco

European journal of radiology

2020 Volume 126, Page(s) 108907

Abstract: Purpose: to assess if tumor segmentation analysis performed at different post-contrast time points (TPs) on dynamic images could influence the extraction of dynamic contrast enhanced (DCE)-MRI parameters in locally advanced breast cancer (LABC), and ... ...

Abstract	Purpose: to assess if tumor segmentation analysis performed at different post-contrast time points (TPs) on dynamic images could influence the extraction of dynamic contrast enhanced (DCE)-MRI parameters in locally advanced breast cancer (LABC), and potentially represent a source of variability. Method: forty patients with forty-two LABC lesions were prospectively enrolled and underwent breast DCE-MRI examination at 3 T. On post-processed dynamic images, enhancing tumor lesions were manually segmented at four different TPs: at the first post-contrast dynamic image in which the lesion was appreciable (TP 1) and at 1, 5 and 10 min after contrast-agent administration (TPs 2, 3 and 4, respectively) and corresponding DCE-MRI parameters were extracted. Friedman's test followed by Bonferroni-adjusted Wilcoxon signed rank test for post-hoc analysis was used to compare DCE-MRI parameters. Intra- and inter-observer reliability of DCE-MRI parameters measurements was assessed using the Intraclass Correlation Coefficient (ICC) analysis. Results: Ktrans, Kep and iAUC were significantly higher when extracted from ROIs placed at TP1 and progressively decreased from TP 2-4. The intra-observer reliability ranged from good to excellent (ICC's: 0.894 to 0.990). The inter-observer reliability varied from moderate to excellent (0.770 to 0.942). The inter-observer reliability was significantly higher for Ktrans and Kep extracted at TPs1 and 2 as compared to TPs 3 and 4. Conclusions: A significant variability of DCE-MRI quantitative parameters occurs when tumor segmentation is performed at different TPs. We suggest to performing tumor delineation at an established TP, preferably the earliest, in order to extract reliable and comparable DCE-MRI data.
MeSH term(s)	Adult ; Aged ; Breast/pathology ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/pathology ; Contrast Media ; Female ; Humans ; Image Enhancement/methods ; Image Interpretation, Computer-Assisted/methods ; Magnetic Resonance Imaging/methods ; Middle Aged ; Reproducibility of Results
Chemical Substances	Contrast Media
Language	English
Publishing date	2020-02-21
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	138815-0
ISSN	1872-7727 ; 0720-048X
ISSN (online)	1872-7727
ISSN	0720-048X
DOI	10.1016/j.ejrad.2020.108907
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