Browsing by Author "Dikić, Srdjan (6508063280)"

Angiosarcoma of the breast is a rare and very aggressive tumors originated from endothelial cells lining blood vessels. We report a case of a 55-year-old postmenopausal female with a primary breast angiosarcoma diagnosed just a one year after radical hysterectomy and radiation therapy due to endometrial cancer. The patient initially presented with postmenopausal bleeding. Cytology and biopsy of the endometrium were performed and endometrial adenosquamous carcinoma was diagnosed followed by radical hysterectomy and postoperative local radiatiotherapy (50 Gy). One year later patient presented with a great painful tumorous mass in the right breast. Physical examination revealed an oval tumor, located in upper and outer quadrant of the right breast, around 15 cm in diameter. Mammography and ultrasonography were performed. The angiosarcoma of the breast was confirmed by biopsy. The patient unDerwent radical mastectomy. Histopathology proved the diagnosis of angiosarcoma (high-grade, numerous mitoses over 10/10 HPF, necrosis, "blood lakes", infiltrative borDers). Differential diagnosis of a breast angiosarcoma should be consiDered in all painful breast tumours no mather the time and the location of the previous radiation treatment even if benign characteristics of these masses have been detected by mammography and breast ultrasound. © 2012 Versita Warsaw and Springer-Verlag Berlin Heidelberg.

Introduction: Lesbian, gay, and bisexuals have unique healthcare needs. Breast cancer is leading cancer in women, worldwide, accounting for 25% of all cases. Annual incidence rates increased significantly in all countries and age groups. The occurrence of breast cancer is rare in transgender population. As they have very limited access to medical care, it is much less likely to pursue breast cancer screening than in other individuals not identified as transgender. Review of the cases from literature: Up to date, only 13 cases of the breast cancer transsexuals (female to male) have been reported in six published papers worldwide. Histological examination of the breast tumor in female-to-male transgender showed progesterone/estrogen-positive invasive ductal carcinoma. Discussion: Gender identity describes a person’s inherent sense of being a woman, man, or of neither gender, whereas sexual orientation refers to how people identify their physical and emotional attraction to others. Gender reassignment surgery, as series of complex surgical genital and non-genital procedures, is recognized as the most effective treatment for patients with gender dysphoria. The two main principles of hormone therapy for transgender patients are to reduce endogenous hormone levels and their associated sex characteristics and replace them with hormones of the preferred sex. Breast cancer infrequently occurs in transgender patients. Even breast core biopsies can be difficult for interpreting after changes in breast tissue in female-to-male transsexuals following gender reassignment. Conclusion: Reviewing the literature, so many different data concerning probability of breast cancer in sexual minority can be found. Breast cancer screening program should be offered to all transgender individuals according to national guidelines. Very important is to take into consideration a transgender person’s natal and surgical anatomy, unique clinical concerns for depression and anxiety, risk of suicide together with risk factors including experiences of harassment or physical or sexual violence, low education level, and unemployment. Understanding the need for mammography in these often marginalized groups is very important in addressing breast cancer disparities despite differences in insurance coverage in some countries and greater concern for the cancer of the breast in residual breast tissue. The best screening rule, ever, for breast cancer in male transsexuals and other similar population should be, besides surgical history and hormonal status, “Screen Now, Screen Regularly and Screen What You Have.”. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Introduction: Lesbian, gay, and bisexuals have unique healthcare needs. Breast cancer is leading cancer in women, worldwide, accounting for 25% of all cases. Annual incidence rates increased significantly in all countries and age groups. The occurrence of breast cancer is rare in transgender population. As they have very limited access to medical care, it is much less likely to pursue breast cancer screening than in other individuals not identified as transgender. Review of the cases from literature: Up to date, only 13 cases of the breast cancer transsexuals (female to male) have been reported in six published papers worldwide. Histological examination of the breast tumor in female-to-male transgender showed progesterone/estrogen-positive invasive ductal carcinoma. Discussion: Gender identity describes a person’s inherent sense of being a woman, man, or of neither gender, whereas sexual orientation refers to how people identify their physical and emotional attraction to others. Gender reassignment surgery, as series of complex surgical genital and non-genital procedures, is recognized as the most effective treatment for patients with gender dysphoria. The two main principles of hormone therapy for transgender patients are to reduce endogenous hormone levels and their associated sex characteristics and replace them with hormones of the preferred sex. Breast cancer infrequently occurs in transgender patients. Even breast core biopsies can be difficult for interpreting after changes in breast tissue in female-to-male transsexuals following gender reassignment. Conclusion: Reviewing the literature, so many different data concerning probability of breast cancer in sexual minority can be found. Breast cancer screening program should be offered to all transgender individuals according to national guidelines. Very important is to take into consideration a transgender person’s natal and surgical anatomy, unique clinical concerns for depression and anxiety, risk of suicide together with risk factors including experiences of harassment or physical or sexual violence, low education level, and unemployment. Understanding the need for mammography in these often marginalized groups is very important in addressing breast cancer disparities despite differences in insurance coverage in some countries and greater concern for the cancer of the breast in residual breast tissue. The best screening rule, ever, for breast cancer in male transsexuals and other similar population should be, besides surgical history and hormonal status, “Screen Now, Screen Regularly and Screen What You Have.”. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Premature ovarian insufficiency (POI) is a delicate medical problem in young women. This condition is not unchangeable and permanent but is associated with intermittent and unpredictable ovarian activity, resulting in low conception rate. Over the period of 8 years, the evaluation of secondary amenorrhea was conducted in 90 patients below the age of 40 who wished to restore fertility. Having confirmed the diagnosis and investigated the etiology of POI, hormone replacement therapy was applied (sequential administration of estradiol and norethisterone acetate) in the first 30 patients (group A). Estrogen–progestogen therapy with daily supplementation of 25 mg of micronized oral dehydroepiandrosterone (DHEA) was conducted in 44 patients (group B), whereas a combined regime (estrogen–progestogen therapy, DHEA supplementation in daily dose of 25 mg, and melatonin supplementation in daily dose of 3 mg) was conducted in 16 patients (group C). In the course of our study, 16 pregnancies were realized (18% of all cases: 17% in group A; 18% in group B; 19% in group C) 6 to 20 months after the initiation of hormone therapy, and there have been 13 completed term pregnancies so far with normal fetal growth and development. We concluded that estrogen–progestogen therapy combined with DHEA and melatonin could optimize fertility and lead to successful pregnancy in POI patients. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Premature ovarian insufficiency (POI) is a delicate medical problem in young women. This condition is not unchangeable and permanent but is associated with intermittent and unpredictable ovarian activity, resulting in low conception rate. Over the period of 8 years, the evaluation of secondary amenorrhea was conducted in 90 patients below the age of 40 who wished to restore fertility. Having confirmed the diagnosis and investigated the etiology of POI, hormone replacement therapy was applied (sequential administration of estradiol and norethisterone acetate) in the first 30 patients (group A). Estrogen–progestogen therapy with daily supplementation of 25 mg of micronized oral dehydroepiandrosterone (DHEA) was conducted in 44 patients (group B), whereas a combined regime (estrogen–progestogen therapy, DHEA supplementation in daily dose of 25 mg, and melatonin supplementation in daily dose of 3 mg) was conducted in 16 patients (group C). In the course of our study, 16 pregnancies were realized (18% of all cases: 17% in group A; 18% in group B; 19% in group C) 6 to 20 months after the initiation of hormone therapy, and there have been 13 completed term pregnancies so far with normal fetal growth and development. We concluded that estrogen–progestogen therapy combined with DHEA and melatonin could optimize fertility and lead to successful pregnancy in POI patients. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Introduction: Post-menopause androgens are the essential precursors for estrogen synthesis through their conversion in peripheral tissues. The main postmenopausal estrogen is estrone, which is also peripherally converted into estradiol. Concentrations of these two estrogens are directly proportional in circulation. We wanted to establish whether there is a direct correlation between body mass and postmenopausal symptoms in surgically castrated women. Materials and methods: We analyzed 30 patients with artificially induced menopause, 3-12 months after the operation (hysterectomy and bilateral adnexectomy). Prior to being put on hormone substitution therapy the following was obtained from the patients: Body Mass Index-BMI (kg/m 2 ), measurement of estradiol (E 2 ) by RIA method, and 12 subjective symptoms analyzed according to intensity and frequency. The relationship between BMI, E 2 level and subjective symptoms were assessed. Results: By analyzing the correlation coefficient it was shown that there was statistically significant causal-consequential connection between the E 2 level and BMI (R 2 =0.1647, p<0.05). There is no strong correlation between BMI and symptoms (R 2 =0.004, p<0.05). However, E 2 level correlated with subjective symptoms (R 2 =0.2123, p<0.05). Conclusions: Estrogen production in postmenopause is dependent on the substrate availability, and thus with adiposity. Therefore, we were surprised by the lack of correlation between BMI and symptoms. This suggests that estrogen metabolism and biological effects are not primarily affected by BMI, and that expression of postmenopausal symptoms does not depend only on estrogen level. © Springer-Verlag 2004.