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The sternalis muscle variation is a well-known anatomical situation. It is present in 8.7% of women and 6.4% of men, although the incidence varies according to sex, race and ethnicity. During a left modified radical mastectomy operation on a 46-year-old female patient a sternalis muscle was detected on the pectoralis major muscle in the superficial fascia. It was in craniocaudal position and was parallel to the body of the sternum. The cylindrical muscle was approximately 8 cm in length and 2 cm in diameter. Such variations are considered to have their origin in embryological development. Awareness of muscular variations and their identification is important both for procedure through the proper dissection planes during breast surgery and in radiological examination and follow-up.
Breast cancer is one of the most common types of cancer among women. The most common form of treatment of this illness is a surgical intervention consisting of a partial or radical mastectomy. This article describes the psychological impacts of this experience on the frequency and occurrence of complications in the sexual activity of women and to determine the role that medical staff can play in helping patients cope with these challenges. The loss of a breast can have negative effects on a woman’s emotional state, specifically in terms of feeling feminine and the relationship with her partner. This is often reflected in a reduced quality of life. The care extended to post-mastectomy patients should routinely include an assessment of possible sexual dysfunctions and monitoring of how such dysfunctions are coped with. The PLISSIT model makes it possible to indicate how post-mastectomy patients may be effectively supported by medical staff. It serves to define a group of patients requiring specialist help. It also aims to initiate a conversation about the difficulties of functioning in this sphere, to provide general information and change existing perceptions, to give specific advice on making referrals to a specialist, and to consider these types of existing problems. The described intervention model is applicable to individual work, as well as to work with couples and groups. This method depends on the type of intervention desired and on the current psychophysical state of the patient and her readiness to start a conversation concerning sexual activity.
The aim of the study was to assess the prognostic value of cell proliferation for the continuing course of the disease after the surgical excision of malignant mammary tumours in female dogs. The expression of the proliferating cell nuclear antigen (PCNA) and Ki-67 antigen has been determined by means of immunohistochemistry in formalin-fixed, paraffin-embedded tumour tissue samples taken during the mastectomy. Differences in the intensity of cell nuclei staining have been observed between the PCNA and Ki-67 antigens. The PCNA index was generally twice as high as that of Ki-67; however, the Ki-67 antigen index achieved higher values in predicting the remission time and survival time than the PCNA index. At the same time, only the mean value of the Ki-67 antigen index was statistically higher in the group of dogs with disease progression, than in the groups of dogs without recurrence and metastases. The PCNA index values demonstrated a positive correlation with the degree of histologic malignancy. The results confirm that the determination of the Ki-67 antigen index has a higher prognostic value, especially in the context of its introduction into a standard histopathological examination.
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