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Tejera-Vaquerizo A, Boada A, Puig S, Nagore E, Fernández-de-Misa R, Ferrándiz L, Conde-Taboada A, Castro E, Richarz NA, Paradela S, Llambrich Á, Salgüero I, Diago A, Samaniego E, Flórez Á, Segura S, Maldonado-Seral C, Coronel-Pérez IM, Tomás-Velázquez A, Rodríguez P, Mayor A, García-Doval I, Grau-Pérez M. Melanoma Registry of the Spanish Academy of Dermatology and Venereology (REGESMEL): Description and Data in its First Year of Operation. Actas Dermosifiliogr 2024:S0001-7310(24)00184-4. [PMID: 38452890 DOI: 10.1016/j.ad.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/06/2023] [Revised: 01/24/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION The incidence of melanoma is rising in Spain. The prognostic stages of patients with melanoma are determined by various biological factors, such as tumor thickness, ulceration, or the presence of regional or distant metastases. The Spanish Academy of Dermatology and Venereology (AEDV) has encouraged the creation of a Spanish Melanoma Registry (REGESMEL) to evaluate other individual and health system-related factors that may impact the prognosis of patients with melanoma. The aim of this article is to introduce REGESMEL and provide basic descriptive data for its first year of operation. METHODS REGESMEL is a prospective, multicentre cohort of consecutive patients with invasive cutaneous melanoma that collects demographic and staging data as well as individual and healthcare-related baseline data. It also records the medical and surgical treatment received by patients. RESULTS A total of 450 cases of invasive cutaneous melanoma from 19 participant centres were included, with a predominance of thin melanomas≤1mm thick (54.7%), mainly located on the posterior trunk (35.2%). Selective sentinel lymph node biopsy was performed in 40.7% of cases. Most cases of melanoma were suspected by the patient (30.4%), or his/her dermatologist (29.6%). Patients received care mainly in public health centers (85.2%), with tele-dermatology resources being used in 21.6% of the cases. CONCLUSIONS The distribution of the pathological and demographic variables of melanoma cases is consistent with data from former studies. REGESMEL has already recruited patients from 15 Spanish provinces and given its potential representativeness, it renders the Registry as an important tool to address a wide range of research questions.
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Affiliation(s)
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
| | - S Puig
- Servicio de Dermatología, Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España; Centro de investigación biomédica en red de enfermedades raras, CIBERER, Barcelona, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - R Fernández-de-Misa
- Servicio de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - L Ferrándiz
- Unidad de Melanoma, Servicio de Dermatología médico-quirúrgico, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A Conde-Taboada
- Servicio de Dermatología, Hospital Clínico San Carlos, Madrid, España
| | - E Castro
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - N A Richarz
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
| | - S Paradela
- Servicio de Dermatología, Complexo Hospitalario A Coruña, A Coruña, España
| | - Á Llambrich
- Servicio de Dermatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - I Salgüero
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - A Diago
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - E Samaniego
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - Á Flórez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur, SERGAS-UVIGO, Pontevedra, España
| | - S Segura
- Servicio de Dermatología, Hospital del Mar de Barcelona, Barcelona, España
| | - C Maldonado-Seral
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, España
| | - I M Coronel-Pérez
- Servicio de Dermatología, Hospital Universitario Virgen de Valme de Sevilla, Sevilla, España
| | - A Tomás-Velázquez
- Servicio de Dermatología, Clínica Universidad de Navarra, Madrid, España
| | - P Rodríguez
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España; Servicio de Dermatología, Hospital Ruber Internacional, Madrid, España
| | - A Mayor
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - I García-Doval
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, España; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, España
| | - M Grau-Pérez
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, España; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
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Ribera-Perianes J, Vega M, Cases Moreno X, Cordón J, Cortés Gracia J, Paredes P, Sánchez-Izquierdo N, Perissinotti A, Fuster Pelfort D, Vidal-Sicart S. Multidisciplinary radio-guided surgery team: Alternative to change the current paradigm. Rev Esp Med Nucl Imagen Mol 2024; 43:91-99. [PMID: 38387785 DOI: 10.1016/j.remnie.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/02/2023] [Indexed: 02/24/2024]
Abstract
INTRODUCTION Given the constant increase in the healthcare demand for examinations related to radio-guided surgery (RGS), our hospital adopted new professional profiles in the RGS team, in order to partially reduce the time spent by nuclear medicine physicians on this task. AIM To analyze the process of incorporating the profiles of Diagnostic Imaging Technician (DIT) and Sentinel Node Referent Nurse (SNRN), evaluating their deployment in the procedures linked to the technique. MATERIAL AND METHODS Analysis of RGS activity during the period 2018-2022, focusing on pre-surgical and surgical procedures related to breast cancer (BC) and malignant melanoma (MM), as they are those pathologies on which the transfer of care competencies was concentrated. Chronological evolution of the competencies assumed by the different profiles during their integration into the RGS team. RESULTS RGS's healthcare activity during the analyzed period experienced an increase of 109%. BC and MM were the pathologies that accounted for by far the greatest demand for care. The transfer of competencies in these two pathologies occurred in a progressive and staggered manner, with 74% (460/622) of the administration phase being carried out by the SNRN and 64% (333/519) of the surgeries by the DIT in 2022. CONCLUSIONS The creation of a multidisciplinary RGS team that includes different professional profiles (nuclear medicine physician [MN], ERGC and TSID) is an effective strategy to respond to the increase in the complexity and number of all procedures related to RGS.
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Affiliation(s)
| | - M Vega
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | - X Cases Moreno
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | - J Cordón
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | - J Cortés Gracia
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | - P Paredes
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | | | - A Perissinotti
- Nuclear Medicine Department, Clínic Barcelona, Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | | | - S Vidal-Sicart
- Nuclear Medicine Department, Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Moreno-Ramírez D, Boada A, Ferrándiz L, Samaniego E, Carretero G, Nagore E, Redondo P, Ortiz-Romero P, Malvehy J, Botella-Estrada R; miembros del Grupo Español de Dermato-Oncología y Cirugía. Academia Española de Dermatología y Venereología. Lymph Node Dissection in Patients With Melanoma and Sentinel Lymph Node Metastasis: An Updated, Evidence-Based Decision Algorithm. Actas Dermosifiliogr (Engl Ed) 2018; 109:390-8. [PMID: 29650221 DOI: 10.1016/j.ad.2018.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 01/26/2018] [Accepted: 02/04/2018] [Indexed: 11/22/2022] Open
Abstract
Recent publication of the results of clinical trials in which lymph node dissection was not associated with any survival benefit in patients with sentinel node metastasis makes it necessary to reconsider the treatment of patients with melanoma. This article provides an update on the available evidence on the diverse factors (routes of metastatic spread, predictors, adjuvant therapy, etc.) that must be considered when treating patients with sentinel node-positive melanoma. The authors propose a decision-making algorithm for use in this clinical setting. The current evidence no longer supports lymph node dissection in patients with low-risk sentinel node metastasis (sentinel node tumor load ≤1mm).
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Nieves Maldonado SM, Pubul Núñez V, Argibay Vázquez S, Macías Cortiñas M, Ruibal Morell Á. Axillary web syndrome following sentinel node biopsy for breast cancer. Rev Esp Med Nucl Imagen Mol 2016; 35:325-8. [PMID: 27246290 DOI: 10.1016/j.remn.2016.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/12/2016] [Revised: 04/08/2016] [Accepted: 04/18/2016] [Indexed: 11/16/2022]
Abstract
A 49 year-old woman diagnosed with infiltrating lobular breast carcinoma, underwent a right mastectomy and sentinel node biopsy (SLNB). The resected sentinel lymph nodes were negative for malignancy, with an axillary lymphadenectomy not being performed. In the early post-operative period, the patient reported an axillary skin tension sensation, associated with a painful palpable cord. These are typical manifestations of axillary web syndrome (AWS), a poorly known axillary surgery complication, from both invasive and conservative interventions. By presenting this case we want to focus the attention on a pathological condition, for which its incidence may be underestimated by not including it in SLNB studies. It is important for nuclear medicine physicians to be aware of AWS as a more common complication than infection, seroma, or lymphoedema, and to discuss this possible event with the patient who is consenting to the procedure.
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Affiliation(s)
- S M Nieves Maldonado
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
| | - V Pubul Núñez
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - S Argibay Vázquez
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - M Macías Cortiñas
- Servicio de Servicio de Ginecología y Obstetricia, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - Á Ruibal Morell
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
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López-Rodríguez E, García-Gómez FJ, Álvarez-Pérez RM, Martínez-Castillo R, Borrego-Dorado I, Fernández-Ortega P, Zulueta-Dorado T. Role of SPECT-CT in sentinel lymph node biopsy in patients diagnosed with head and neck melanoma. Rev Esp Med Nucl Imagen Mol 2015; 35:22-8. [PMID: 26150109 DOI: 10.1016/j.remn.2015.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/27/2015] [Revised: 05/21/2015] [Accepted: 05/25/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Assess the role of SPECT-CT in sentinel lymph node (SLN) biopsy in the accurate anatomical location of the SNL in patients with cutaneous head and neck melanoma. MATERIAL AND METHODS A retrospective study was conducted from February 2010 to June 2013 on 22 consecutive patients with a diagnosis of cutaneous head and neck melanoma (9 female, 13 male), with a mean age of 55 years old and who met the inclusion criteria for SLN biopsy. Patients underwent preoperative scanning after peri-scar injection of (99m)Tc-labeled-nanocolloid. Planar images of the injection-site, whole-body, and SPECT-CT scanning were acquired. RESULTS Detection rate of SLN reached up to 91% (20/22 patients) by planar lymphoscintigraphy and 95.4% (21/22 patients) by SPECT-CT. SPECT-CT provided an accurate location of SLN in 14/22 patients, enabling to improve the surgical approach (clinical impact: 63.6%). SLN was positive for metastatic cells in 9.1% patients. CONCLUSION SPECT-CT provides detailed anatomical SLN location and allows detecting a higher number of SLN than planar lymphoscintigraphy. Routine use of SPECT-CT is recommended in order to optimise the SLN detection and location in patients with head and neck melanoma.
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Affiliation(s)
- E López-Rodríguez
- Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - F J García-Gómez
- Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - R M Álvarez-Pérez
- Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - R Martínez-Castillo
- Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - I Borrego-Dorado
- Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - P Fernández-Ortega
- Servicio de Cirugía Plástica General, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - T Zulueta-Dorado
- Servicio de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla, España
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Peral Rubio F, de La Riva P, Moreno-Ramírez D, Ferrándiz-Pulido L. Portable gamma camera guidance in sentinel lymph node biopsy: prospective observational study of consecutive cases. Actas Dermosifiliogr 2015; 106:408-14. [PMID: 25765503 DOI: 10.1016/j.ad.2014.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 03/12/2014] [Revised: 11/04/2014] [Accepted: 11/29/2014] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Sentinel lymph node biopsy is the most important tool available for node staging in patients with melanoma. OBJECTIVES To analyze sentinel lymph node detection and dissection with radio guidance from a portable gamma camera. To assess the number of complications attributable to this biopsy technique. METHODS Prospective observational study of a consecutive series of patients undergoing radioguided sentinel lymph node biopsy. We analyzed agreement between nodes detected by presurgical lymphography, those detected by the gamma camera, and those finally dissected. RESULTS A total of 29 patients (17 women [62.5%] and 12 men [37.5%]) were enrolled. The mean age was 52.6 years (range, 26-82 years). The sentinel node was dissected from all patients; secondary nodes were dissected from some. In 16 cases (55.2%), there was agreement between the number of nodes detected by lymphography, those detected by the gamma camera, and those finally dissected. The only complications observed were seromas (3.64%). No cases of wound dehiscence, infection, hematoma, or hemorrhage were observed. CONCLUSIONS Portable gamma-camera radio guidance may be of use in improving the detection and dissection of sentinel lymph nodes and may also reduce complications. These goals are essential in a procedure whose purpose is melanoma staging.
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Affiliation(s)
- F Peral Rubio
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España.
| | - P de La Riva
- Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España
| | - D Moreno-Ramírez
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - L Ferrándiz-Pulido
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
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Sánchez Aguilar M, Álvarez Pérez RM, García Gómez FJ, Fernández Ortega P, Borrego Dorado I. Sentinel lymph node biopsy in paediatric melanoma. A case series. Rev Esp Med Nucl Imagen Mol 2015; 34:317-20. [PMID: 25595513 DOI: 10.1016/j.remn.2014.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 11/25/2014] [Accepted: 11/25/2014] [Indexed: 11/17/2022]
Abstract
The incidence of melanoma in children is uncommon, being particularly rare in children under 10 years-old. However, this disease is increasing by a mean of 2% per year. As in adults, the lymph node status is the most important prognostic factor, crucial to performing the selective sentinel lymph node biopsy (SLNB). We report 3 cases of paediatric patients of 3, 4 and 8 years-old, in which SLNB was performed for malignant melanoma. Paediatric age implies greater technical difficulty to the scintigraphy scan due to poor patient cooperation, with mild sedation required in some cases, and only being able to acquire planar images in other cases. SPECT/CT was only performed in the oldest patient. In our cases, SLNB was useful for selecting the least invasive surgery in order to reduce morbidity.
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Affiliation(s)
- M Sánchez Aguilar
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - R M Álvarez Pérez
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - F J García Gómez
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - P Fernández Ortega
- Servicio de Dermatología y Venereología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - I Borrego Dorado
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
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Sabaté-Llobera A, Notta PC, Benítez-Segura A, López-Ojeda A, Pernas-Simon S, Boya-Román MP, Bajén MT. [Selective biopsy of the sentinel lymph node in patients with breast cancer and previous excisional biopsy: is there a change in the reliability of the technique according to time from surgery?]. Rev Esp Med Nucl Imagen Mol 2014; 34:9-12. [PMID: 25455507 DOI: 10.1016/j.remn.2014.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 08/19/2014] [Revised: 09/27/2014] [Accepted: 09/30/2014] [Indexed: 11/28/2022]
Abstract
AIM To assess the influence of time on the reliability of sentinel lymph node biopsy (SLNB) in breast cancer patients with previous excisional biopsy (EB), analyzing both the sentinel lymph node detection and the lymph node recurrence rate. MATERIAL AND METHODS Thirty-six patients with cT1/T2 N0 breast cancer and previous EB of the lesion underwent a lymphoscintigraphy after subdermal periareolar administration of radiocolloid, the day before SLNB. Patients were classified into two groups, one including 12 patients with up to 29 days elapsed between EB and SLNB (group A), and another with the remaining 24 in which time between both procedures was of 30 days or more (group B). Scintigraphic and surgical detection of the sentinel lymph node, histological status of the sentinel lymph node and of the axillary lymph node dissection, if performed, and lymphatic recurrences during follow-up, were analyzed. RESULTS Sentinel lymph node visualization at the lymphoscintigraphy and surgical detection were 100% in both groups. Histologically, three patients showed macrometastasis in the sentinel lymph node, one from group A and two from group B. None of the patients, not even those with malignancy of the sentinel lymph node, relapsed after a medium follow-up of 49.5 months (24-75). CONCLUSION Time elapsed between EB and SLNB does not influence the reliability of this latter technique as long as a superficial injection of the radiopharmaceutical is performed, proving a very high detection rate of the sentinel lymph node without evidence of lymphatic relapse during follow-up.
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Affiliation(s)
- A Sabaté-Llobera
- Servicio de Medicina Nuclear, Hospital Universitari de Bellvitge - IDIBELL, Barcelona, España.
| | - P C Notta
- Servicio de Medicina Nuclear, Hospital Universitari de Bellvitge - IDIBELL, Barcelona, España
| | - A Benítez-Segura
- Servicio de Medicina Nuclear, Hospital Universitari de Bellvitge - IDIBELL, Barcelona, España; Unidad Funcional de Mama, Hospital Universitari de Bellvitge - IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - A López-Ojeda
- Servicio de Cirugía Plástica, Hospital Universitari de Bellvitge - IDIBELL, Barcelona, España; Unidad Funcional de Mama, Hospital Universitari de Bellvitge - IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - S Pernas-Simon
- Servicio de Oncología Médica, Institut Català d'Oncologia - Hospital Duran i Reynals, Barcelona, España; Unidad Funcional de Mama, Hospital Universitari de Bellvitge - IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - M P Boya-Román
- Servicio de Medicina Nuclear, Hospital Universitari de Bellvitge - IDIBELL, Barcelona, España
| | - M T Bajén
- Servicio de Medicina Nuclear, Hospital Universitari de Bellvitge - IDIBELL, Barcelona, España; Unidad Funcional de Mama, Hospital Universitari de Bellvitge - IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
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