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Bukovszky B, Fodor J, Mátrai Z, Dorogi B, Zongor Z, Mihály D, Polgár C, Major T. Radiotherapy instead of axillary lymph node dissection: evaluation of axillary lymph node dose coverage with whole breast radiotherapy. Rep Pract Oncol Radiother 2022; 27:458-466. [PMID: 36186703 PMCID: PMC9518762 DOI: 10.5603/rpor.a2022.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background The purpose of this study was to investigate the dose coverage of sentinel lymph nodes (SLN), level I, II and III axillary volumes from tangent fields for breast cancer patients with positive SLN without axillary dissection. Materials and methods In 30 patients with cN0 invasive breast cancer treated with breast conserving surgery and SLN biopsy, the SLN area was intraoperatively marked with a titanium clip. Retrospectively, the SLN area and axillary target volumes were contoured, and three plans [standard tangent fields (STgF), high tangent fields (HTgF), and STgF + axillary-supraclavicular field] were generated for each patient. The prescribed dose was standardized to 50 Gy in 2 Gy fractions to the isocenter. Results The mean dose with STgF or HTgF was 33.1 and 49.1 Gy (p = 0.0001) in the SLN area, 25.7 and 45.1 Gy (p < 0.0001) in the volume of level I, 7.2 and 28.9 Gy (p < 0.0001) in the level II and 3.5 and 12.7 Gy (p = 0.0003) in the level III. Adequate therapeutic doses to the level II or III volumes were delivered only with STgF + axillary-supraclavicular field. The mean dose of ipsilateral lung was the highest with the three-field-technique, 9.9 Gy. SLN area, level I, II or III were completely included in the HTgF with 93.3%, 73.3%, 13.3% and 0%, respectively. Conclusions SLN area should be marked by surgical clip and axillary target volumes should be contoured to obtain accurate dose estimations. The use of HTgF improve axillary coverage.
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Dorogi B, Mátrai T, Újhelyi M, Kenessey I, Kelemen P, Sávolt Á, Huszár O, Ping O, Pukancsik D, Mátrai Z. Assessing the needs of Hungarian breast cancer patients for modern oncoplastic breast surgical treatment.
Questionnaire study of 500 patients. Orv Hetil 2020; 161:1221-1228. [PMID: 32628622 DOI: 10.1556/650.2020.31768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 03/19/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The significant need for breast reconstruction resulting from the spread of oncoplastic breast surgery raises a number of systemic issues. Clarification and regulation of the indications are needed for aesthetic changes of the reconstructed breast due to oncotherapy treatments, ageing and technical problems of implants; a number of operations, targeted aesthetic goals as well as surgical capacities and financial background should also be determined. AIM Our aim was to conduct a survey on the opinions and needs of the Hungarian breast cancer population about a modern breast reconstruction system. PATIENT AND METHOD A study was conducted enrolling 500 patients who underwent mastectomy with immediate or delayed reconstruction. A structured questionnaire containing eleven questions was used to measure the attitude for loss and reconstruction of breast, the expectation of cosmetic outcome and qualification of the operating surgeon and the needs relating to the health system and funding. RESULTS The median age was 47 years (min.-max.: 26-73), 59% (n = 294) was married and 52% (n = 260) had graduated in university. The majority of women (70%; n = 348) would like to have nakedly also similar breasts after the reconstruction process. To achieve this, 43% (n = 217) and 37% (n = 184) would undergo maximum two or four procedures, respectively, supported by the national health insurance company. 86% (n = 430) would like to choose qualified breast surgeon for her treatment. CONCLUSION The modern oncoplastic treatment raises complex, systemic issues. Women with breast cancer would like to have qualified breast surgeons restoring their breasts by two operations, all funded by the national health insurance company. Orv Hetil. 2020; 161(29): 1221-1228.
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Affiliation(s)
- Bence Dorogi
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122.,Sebészeti, Érsebészeti és Mellkassebészeti Osztály,Bajcsy-Zsilinszky Kórház és Rendelőintézet, Budapest
| | - Tamás Mátrai
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122
| | - Mihály Újhelyi
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122
| | - István Kenessey
- Nemzeti Rákregiszter,Országos Onkológiai Intézet, Budapest.,Általános Orvostudományi Kar, II. Patológiai Intézet,Semmelweis Egyetem, Budapest
| | - Péter Kelemen
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122
| | - Ákos Sávolt
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122
| | - Orsolya Huszár
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122
| | - Orsolya Ping
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122
| | - Dávid Pukancsik
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122
| | - Zoltán Mátrai
- Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet, Budapest, Ráth Gy. u. 7-9., 1122
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Dorogi B, Újhelyi M, Kenessey I, Ivády G, Mátrai Z. Clinicopathological correlations of areola-sparing mastectomies versus nipple-sparing mastectomies: Analysis of the oncological and cosmetic importance of the components of the nipple-areola complex. Breast J 2020; 26:2081-2086. [PMID: 32613690 DOI: 10.1111/tbj.13957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Bence Dorogi
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Mihály Újhelyi
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - István Kenessey
- National Cancer Registry, National Institute of Oncology, Budapest, Hungary
| | - Gabriella Ivády
- Department of Molecular Pathology, National Institute of Oncology, Budapest, Hungary
| | - Zoltán Mátrai
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
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Dorogi B, Matrai T, Bukovszky B, Savolt A, Polgar C, Kelemen P, Kovacs T, Renyi-Vamos F, Ivady G, Kovacs E, Teglas M, Kasler M, Matrai Z. Mapping of the functional anatomy of lymphatic drainage to the axilla in early breast cancer: a cohort study of 933 cases. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kugler S, Nagy N, Tokes AM, Racz G, Dorogi B, Nemeskeri A. 587Cardiomyocytes exhibiting purkinje-type morphology and prominent connexin 45 immunoreactivity in the myocardial sleeves of cardiac veins are strongly positive for desmin. Europace 2018. [DOI: 10.1093/europace/euy015.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Kugler
- Semmelweis University Heart Center, Budapest, Hungary
| | - N Nagy
- Semmelweis University, Department of Anatomy, Histology and Embryology, Budapest, Hungary
| | - A M Tokes
- Semmelweis University, 2nd Department of Pathology, Budapest, Hungary
| | - G Racz
- Semmelweis University, 1st Department of Pathology and Experimental Cancer Research, Budapest, Hungary
| | - B Dorogi
- Semmelweis University, Department of Anatomy, Histology and Embryology, Budapest, Hungary
| | - A Nemeskeri
- Semmelweis University, Department of Anatomy, Histology and Embryology, Budapest, Hungary
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Kugler S, Nagy N, Rácz G, Tőkés AM, Dorogi B, Nemeskéri Á. Presence of cardiomyocytes exhibiting Purkinje-type morphology and prominent connexin45 immunoreactivity in the myocardial sleeves of cardiac veins. Heart Rhythm 2018; 15:258-264. [DOI: 10.1016/j.hrthm.2017.09.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Indexed: 02/04/2023]
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Dezső K, Rókusz A, Bugyik E, Szücs A, Szuák A, Dorogi B, Kiss M, Nemeskéri Á, Nagy P, Paku S. Erratum to "Human liver regeneration in advanced cirrhosis is organized by the portal tree" [J Hepatol 66 (2017) 778-786]. J Hepatol 2017; 67:430-436. [PMID: 28716380 DOI: 10.1016/j.jhep.2017.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Katalin Dezső
- Semmelweis University, First Department of Pathology and Experimental Cancer Research, Budapest, Hungary
| | - András Rókusz
- Semmelweis University, First Department of Pathology and Experimental Cancer Research, Budapest, Hungary
| | - Edina Bugyik
- Semmelweis University, First Department of Pathology and Experimental Cancer Research, Budapest, Hungary
| | - Armanda Szücs
- Semmelweis University, First Department of Pathology and Experimental Cancer Research, Budapest, Hungary
| | - András Szuák
- Semmelweis University, Department of Anatomy, Histology and Embryology, Budapest, Hungary
| | - Bence Dorogi
- Department of Surgery, Budai Irgalmasrendi Hospital, Budapest, Hungary
| | - Mátyás Kiss
- Semmelweis University, Department of Anatomy, Histology and Embryology, Budapest, Hungary
| | - Ágnes Nemeskéri
- Semmelweis University, Department of Anatomy, Histology and Embryology, Budapest, Hungary
| | - Péter Nagy
- Semmelweis University, First Department of Pathology and Experimental Cancer Research, Budapest, Hungary
| | - Sándor Paku
- Semmelweis University, First Department of Pathology and Experimental Cancer Research, Budapest, Hungary; Tumor Progression Research Group, Joint Research Organization of the Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary.
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Dorogi B, Gulyás G, Kunos C, Udvarhelyi N, Mátrai Z. Contralateral axillary silicone lymphadenopathy after modified radical mastectomy and reconstruction. Eur J Plast Surg 2014. [DOI: 10.1007/s00238-014-0970-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rosero O, Németh K, Turóczi Z, Fülöp A, Garbaisz D, Győrffy A, Szuák A, Dorogi B, Kiss M, Nemeskéri Á, Harsányi L, Szijártó A. Collateral circulation of the rat lower limb and its significance in ischemia-reperfusion studies. Surg Today 2014; 44:2345-53. [PMID: 24374367 DOI: 10.1007/s00595-013-0822-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 12/10/2013] [Indexed: 01/28/2023]
Abstract
PURPOSE Rats are the most commonly used animal model for studies of acute lower limb ischemia-reperfusion. The ischemia induced by arterial clamping may cause milder damage than the application of a tourniquet if the presence of a possible collateral system is considered. METHODS Male Wistar rats were randomized into three groups: in group A, the muscle weight affected by ischemia was measured; in group B, the severity of muscle damage caused by the application of a tourniquet and by infrarenal aortic occlusion was examined. Blood and muscle samples were taken from group B to assess the serum necroenzyme, potassium and TNF-α levels, as well as the muscle fiber viability and for histological examinations. In group C, the identification of the lower limb collateral system was performed using corrosion casting. RESULTS Tourniquet application affected the lower muscle mass and resulted in significantly more severe injury compared to infrarenal aortic occlusion. This difference was reflected in the serum necroenzyme, potassium and TNF-α levels. The histological examination and viability assay confirmed these findings. The corrosion casts showed several anastomoses capable of supplying the lower limb. CONCLUSION Tourniquet application proved to be capable of inducing absolute lower limb ischemia, in contrast to infrarenal aortic ligation, where a rich collateral system is considered to help mitigate the injury.
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Affiliation(s)
- Olivér Rosero
- 1st Department of Surgery, Semmelweis University, 78 Ulloi Street, Budapest, 1082, Hungary,
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Mátrai Z, Tóth L, Saeki T, Sinkovics I, Godény M, Takeuchi H, Bidlek M, Bartal A, Sávolt A, Dorogi B, Kásler M. [The potential role of SPECT/CT in the preoperative detection of sentinel lymph nodes in breast cancer]. Orv Hetil 2011; 152:678-88. [PMID: 21464026 DOI: 10.1556/oh.2011.29077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Regional lymph node status is the most important prognostic factor in breast cancer. Sentinel lymph node biopsy is the standard method of axillary staging in early breast cancer patients with clinically negative nodes. Preoperative lymphoscintigraphy might support refining biopsy findings by determining the number and location of sentinel lymph nodes. In aged or overweight patients, in the presence of atypical or extra-axillary lymphatic drainage, non-visualized lymph nodes, or sentinel lymph nodes close to the isotope injection site, detection could be aided by a new, hybrid imaging tool: the single-photon emission computed tomography combined with computed tomography (3D SPECT/CT). For the first time in Hungarian language, authors overview the literature: all 14 English-language articles on the implementation of 3D SPECT/CT in sentinel lymph node detection in breast cancer are included. It is concluded that 3D SPECT/CT increases the success rate and quality of preoperative sentinel node identification, and is capable of providing a more accurate staging of breast cancer patients in routine clinical practice.
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Affiliation(s)
- Zoltán Mátrai
- Országos Onkológiai Intézet Általános és Mellkassebészeti Osztály Budapest Ráth György u. 7-9. 1122.
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