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  1. Fulltext A rare invasive male breast cancer of nonspecific type presenting at a primary care clinic: Importance of early diagnosis and management
    Mansoor NS, Arifin F, Kornain NKM, Razalli MM
    J Family Community Med, 2023;30(1):65-67.
    PMID: 36843866 DOI: 10.4103/jfcm.jfcm_210_22
    Male breast cancer is a rare disease with an incidence rate of <1% of all breast cancer cases, and only 1% of all male malignancies. Men tend to present at an older age and with more advanced stages compared to women. We report a case of a 74-year-old man who presented at a primary care clinic with a right subareolar painless breast mass. A mammogram and core biopsy were performed. A diagnosis of right invasive breast carcinoma was rendered. The patient underwent a right total mastectomy with ipsilateral axillary lymph node dissection, which revealed an invasive ductal carcinoma of no special type (NST). Chemotherapy, radiotherapy, and hormonal therapy were included in the adjuvant treatment plan. In this report, we discuss the important role of the primary care physician (PCP) in early diagnosis and referral for definitive management. The PCP also plays an essential role in the holistic care of male breast cancer patients, including the management of physical, psychological, social, and underlying chronic diseases.
  2. 2D shear wave elastography for the assessment of quadriceps entheses-a methodological study
    Leong SS, Wong JHD, Rozalli FI, Yahya F, Tee YC, Yamin LSM, et al.
    Skeletal Radiol, 2024 Mar;53(3):455-463.
    PMID: 37594519 DOI: 10.1007/s00256-023-04425-1
    OBJECTIVE: To establish the scanning protocol for 2-dimensional shear wave elastography (SWE) on normal entheses by investigating the possible confounding factors that may increase the variability of measured elasticity.

    MATERIAL AND METHODS: 30 normal quadriceps entheses were scanned using SWE to compare the stiffness and coefficient variation by changing the ultrasonic coupling gel thickness, knee position, region of interest size, and scanning plane.

    RESULTS: No significant difference in median shear wave velocity (SWV) was observed in different coupling gel thicknesses. The median SWV was higher in the knee flexion position than in the extended position (p mm than 2.0 mm (p = 0.001). The median SWV was higher in the transverse plane than in the longitudinal plane (p mm, and a longitudinal plane (p > 0.05). For interobserver reliability for the proposed protocol, the intraclass correlation coefficients was 0.763.

    CONCLUSION: In this study, we determined supine position with the knee extended; using 2.0 mm diameter region of interest and image acquisition at the longitudinal plane with thicker layer coupling gel seems most appropriate to reliably image healthy quadriceps entheses with SWE.

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