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M Leidenius

Publications and source records attributed to M Leidenius.

16 recordsLinked to original sources
PubMed2006

Tumour-positive sentinel node findings in patients with ductal carcinoma in situ.

BACKGROUND: Our aim was to evaluate the prevalence of and risk factors for tumour-positive sentinel node (SN) findings in patients with ductal carcinoma in situ (DCIS). METHODS: Altogether 1,470 patients underwent sentinel node biopsy (SNB) between April 2001 and March 2005 in our unit. According to a histopathological review, 11 of them had microinvasive and 74 pure DCIS and were included in the study. RESULTS: Five patients (7%) with pure DCIS had SN metastases. Three of them had isolated tumour cells (ITC) only. Axillary clearance without further metastatic findings was performed in three patients. The median histological size of DCIS was larger, 50 (45-60) mm in patients with metastatic SN findings than the median of 18 (2-110) mm in those with tumour-negative SN, P=0.0103. All five patients with metastatic SN findings underwent mastectomy. Metastatic SN findings were detected in one (9%) patient with microinvasive DCIS. CONCLUSIONS: Metastatic SN findings in patients with pure DCIS may be a sign of missed invasion.

Adult↗
PubMed2006

The prevalence of axillary lymph-node metastases in patients with pure tubular carcinoma of the breast and sentinel node biopsy.

AIMS: We aimed to evaluate the prevalence of and the risk factors for axillary lymph-node metastases in pure tubular carcinoma (PTC) of the breast. The role of axillary staging and treatment in PTC was also evaluated. METHODS: Between March 2001 and August 2004, 33 PTC patients underwent sentinel node (SN) biopsy as a part of their surgical treatment. Level I/II axillary clearance was carried out in case of tumour positive SN findings. To confirm the correct histological diagnosis (PTC, >90% tubular component), the breast tumours were reviewed by an expert breast pathologist. RESULTS: The SN were successfully harvested in all patients. The median number of SN harvested in the axilla was 3 (range 1-10). Nine (27%) of the 33 patients had axillary nodal metastases. The median number of metastatic nodes was 1 (range 1-3). The median size of the SN metastases was 0.5 mm (mean 1.7 mm, range 0.4-5 mm). In six patients, micrometastases were the only tumour positive SN findings. The median histological tumour size was similar, 9 vs 10mm, in patients with or without axillary metastases. The median patient age was 54 (range 44-71) and 57 (range 39-80) years, respectively. After the histopathological review, six of the 27 patients with true PTC had axillary metastases. The review did not significantly change the risk factors for axillary metastases. CONCLUSIONS: Every fourth PTC patient has axillary lymph-node metastases, most often micrometastases. SN biopsy appears as a feasible method for axillary staging in PTC patients.

Adenocarcinoma↗
PubMed2005

The consequences of long-time arm morbidity in node-negative breast cancer patients with sentinel node biopsy or axillary clearance.

BACKGROUND: The aim was to evaluate long-time morbidity in breast cancer patients 3 years after sentinel node biopsy (SNB) or axillary clearance (AC) emphasizing the consequences of morbidity like work-related events and the need of physiotherapy. PATIENTS AND METHODS: Morbidity was evaluated in 92 breast cancer patients 3 years after SNB only and in 47 patients after AC using a questionnaire. The circumferences of the upper extremities and the range of the shoulder movements were also measured. RESULTS: Two SNB and eight AC patients were not able to use the ipsilateral upper extremity to former extent P < 0.005. One SNB and one AC patient were retired or on a long-time sick leave because of arm morbidity. Clinically apparent upper extremity lymphoedema was observed in one SNB patient and in six AC patients, P < 0.005. Two SNB patients had received manual lymph drainage, one of them because of breast oedema. Seven patients had received manual lymph drainage after AC, three of them wore also compression sleeve, P < 0.05 between AC and SNB. CONCLUSIONS: The risk of remarkable long-time arm morbidity after SNB is minimal. Work-related events seem uncommon due to arm morbidity, regardless of the extent of axillary surgery.

Adult↗
PubMed2005

One-year morbidity after sentinel node biopsy and breast surgery.

Posttreatment morbidity within 1 year after sentinel node biopsy was evaluated objectively by physical examination and also by evaluating patients self-reports of symptoms in a questionnaire. These patients were compared with patients who underwent axillary clearance. At 2 weeks after surgery patients who had undergone sole sentinel node biopsy had made significantly better recoveries than those who had undergone axillary clearance. Although every fourth patient complained of at least mild arm symptoms 1 year after sole SNB, the risk of severe long-term morbidity is minimal. In particular, the risk of disabling lymphoedema seems to be negligible after SNB only.

Activities of Daily Living↗
PubMed2004

The impact of sentinel node biopsy and axillary staging strategy on hospital costs.

BACKGROUND: The aim of the study was to evaluate total hospital costs of three different sentinel node biopsy (SNB) protocols compared to those of diagnostic axillary lymph node dissection (ALND). PATIENTS AND METHODS: The study included 237 consecutive breast cancer patients who underwent SNB with frozen section diagnosis. The sequence of the treatment procedures for each patient was recorded. The sequences of treatment procedures for the same patients were evaluated using three hypothetical scenarios: diagnostic ALND, SNB without frozen section diagnosis and SNB as day case surgery prior to the breast operation. The total hospital costs were calculated in all protocols. RESULTS: The hospital costs per patient were 3750euro;. The hospital costs per patient would have been 3020euro; when using the ALND model, 4087euro; had the frozen section not been applied and 4573euro; using 'SNB as day case surgery' model. The costs with or without frozen section diagnosis would have been equal with a threshold false negative rate of 35%. CONCLUSIONS: SNB seems to be associated with higher hospital costs than diagnostic ALND. Frozen section diagnosis seems to be worthwhile as long as the false negative rate is <35%.

Adult↗
PubMed2003

The sensitivity of axillary staging when using sentinel node biopsy in breast cancer.

AIMS: We aimed to study factors, which enhance the sensitivity of sentinel node biopsy. METHODS: Three hundred and sixty-three clinically node negative breast cancer patients with successful sentinel node biopsy were studied. All focally radioactive and/or blue nodes in the axilla were harvested. All palpably suspicious lymph nodes were also removed for a similar histological evaluation. RESULTS: Sentinel node metastases were found in 129 patients. The metastasis was detected in the three first retrieved sentinel nodes in 126 cases and in the fourth or fifth node in three cases. The 'hottest' sentinel node was not the involved one in 18 cases. Five patients with tumour negative sentinel nodes had metastases in other palpably suspicious nodes. CONCLUSIONS: Harvesting all focally radioactive and/or blue nodes and other palpably suspicious nodes minimises the false negative rate in sentinel node biopsy. Removal of more than five nodes does not significantly improve the sensitivity of axillary staging.

Adult↗
PubMed2002

The effect of patient and tumour characteristics on visualization of sentinel nodes after a single intratumoural injection of Tc 99m labelled human albumin colloid in breast cancer.

AIMS: The aim of the study was to study the influence of patient- or tumour-related factors on the lymphatic drainage patterns in breast cancer. METHODS: The study included 290 consecutive breast cancer patients with lymphatic mapping and sentinel node biopsy. Lymphoscintigraphy was performed a median of four hours after a single intratumoral injection of (99m)Tc labelled human albumin colloid with two different particle sizes. RESULTS: Lymphoscintigraphy showed axillary sentinel nodes in 253 (87%) and parasternal sentinel nodes in 49 (17%) patients. The median number of nodes seen in the axilla was one (range 0-5). No sentinel nodes were visualized in 27 (9%) patients. The number of the visualized axillary nodes was influenced by the particle size of the radiocolloid, and by metastatic involvement of the axillary nodes and the age and body mass index (BMI) of the patient. Patients with parasternal sentinel nodes were younger, had a lower BMI and had more often a non-palpable tumour. CONCLUSIONS: The age and BMI of the patient and the palpability of the tumour influence lymphatic drainage patterns in breast cancer. The metastatic involvement of axillary nodes seems to modify lymphatic drainage to the axilla.

Adult↗
PubMed2001

Hepatobiliary carcinoma in primary sclerosing cholangitis: a case control study.

BACKGROUND/AIMS: [corrected] Hepatobiliary carcinoma (HBC) has been considered to be a late complication of end-stage primary sclerosing cholangitis (PSC). The incidence of HBC is approximately 20% in PSC patients evaluated for liver transplantation. The diagnosis of HBC is difficult, at least at an early stage and the prognosis is poor even after liver transplantation. The aim of the study was to look for signs and risk factors for developing hepatobiliary carcinoma in patients with PSC. METHODS: Thirty-six consecutive patients with PSC and HBC (32 with bile duct carcinoma, BDC, and four with hepatocellular carcinoma, HCC) were pair-matched to control patients referred for liver transplantation because of PSC but who did not have HBC. Gender and age at referral were used as matching factors. Clinical and biochemical data were registered. RESULTS: PSC patients with BDC had a shorter median duration of PSC (1 year) compared with the controls (7 years) and PSC patients with HCC (8 years). There were no statistically significant differences in the liver biochemistry between the patient groups. Varices were more common in patients with PSC and HCC (100%) than in controls (56%) or patients with PSC and HBC (12%) (P < 0.0005). CONCLUSIONS: The relatively short duration of PSC and the absence of varices in patients with BDC suggest that BDC, unlike HCC, is not necessarily a late complication of end-stage PSC, as was previously assumed.

Adolescent↗
PubMed1996

Inverse correlation between Helicobacter pylori infection and inflammatory bowel disease.

AIMS: To determine the seroprevalence of Helicobacter pylori in patients with Crohn's disease or ulcerative colitis and in controls without inflammatory bowel disease (IBD). METHODS: One hundred consecutive patients with Crohn's disease, 100 consecutive patients with ulcerative colitis, and 100 age and sex matched controls were studied. Serum H pylori IgG and IgA antibody titres were measured by enzyme immunoassay. RESULTS: The seroprevalence of H pylori was 15% in patients with IBD (13% in patients with Crohn's disease and 18% in patients with ulcerative colitis), whereas the corresponding figure for the controls was 43%. When compared with controls, the seroprevalence of H pylori in patients with IBD was considerably lower in all age groups tested. There was no important difference in treatment with sulphasalazine or in any other medical therapy administered to H pylori positive and negative patients. At the time of blood sampling there was no difference in the level of education or in the employment status between the patients and the controls. CONCLUSIONS: Patients with IBD were less likely to be infected with H pylori than their age and sex matched controls. Neither medical treatment nor socioeconomic factors could explain the difference.

Adolescent↗
PubMed1994

The true extent of ulcerative colitis? A radiological, endoscopic and histological study.

Twenty-six radiological, endoscopic and histological examinations of the large bowel were performed in 25 patients with ulcerative colitis. Extensive colitis was observed in 42% of the radiological, in 38% of the endoscopic, and in 27% of the histological examinations. Agreement as to the extent of the colitis between all three examination methods was reached in 53% of the cases. The endoscopic extent of colitis varied between left-sided and extensive in 41% of the patients during a 7-year median follow-up. The frequent change in the extent of ulcerative colitis and the considerable disagreement between radiography, colonoscopy and histology in evaluating the extent of colitis justify the question, "Does a true, unambiguous extent of colitis really exist?" It is more likely that the extent of colitis is just a function of time and the examination method used.

Adolescent↗
PubMed1994

[Pyomyositis].

Explore the source record for details and available documents.

Adult↗
PubMed1991

Dysplasia and carcinoma in longstanding ulcerative colitis: an endoscopic and histological surveillance programme.

From 1976 to 1989 a total of 66 patients with longstanding ulcerative colitis were entered in a colonoscopic surveillance programme in order to detect dysplasia. Thirty patients had extensive or total ulcerative colitis and 36 left sided colitis. The median duration of the disease at the end of the follow up was 15.0 years. Altogether 182 colonoscopies (2.8 per patient), each involving approximately 20 biopsies from different sites of the colon, were performed. In the total or extensive colitis group, five patients had low grade and one patient had high grade dysplasia. In the left sided colitis group, three patients had low grade dysplasia. In three patients low grade dysplasia was detected in a macroscopic lesion or mass of colonic mucosa. Sixty per cent of the dysplasia specimens were from the right colon. The incidence of dysplasia was higher in patients with extensive colitis and increased with the duration of the disease. None of the patients have so far developed colorectal carcinoma. Our results indicate that a colonoscopic surveillance programme is a safe alternative to prophylactic colectomy in longstanding ulcerative colitis.

Adolescent↗
PubMedDate not supplied

Sentinel nodes outside level I-II of the axilla and staging in breast cancer.

BACKGROUND: The aim of the study was to evaluate the incidence of sentinel nodes and sentinel node metastases outside levels I-II of the axilla in breast cancer. PATIENTS AND METHODS: Altogether 170 breast cancer patients with 172 clinically node-negative T1-T2 tumours underwent lymphoscintigraphy and were included in a prospective study. RESULTS: The lymphoscintigraphy showed sentinel node(s) in the axilla in 150 (87%) breast cancer cases. Thirty (17%) patients had sentinel nodes outside the axilla. Lymphatic drainage solely outside the axilla was encountered in two patients. Lymph node metastases were found in the axilla in 40% and outside the axilla in 17% of the 30 patients with extra-axillary sentinel nodes. Two patients with sentinel node metastases outside the axilla had no axillary metastases. CONCLUSION: The biopsy of sentinel nodes outside the axilla is a potential tool for more accurate staging in breast cancer, since it provides additional information as compared to axillary staging alone.

Adult↗