Author: Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉In 2019, more than 50,000 estimated new thyroid cancers will be diagnosed, which represent approximately 3% of new cancer cases in the U.S. (source: https://seer.cancer.gov)

👉En el 2019, se diagnosticarán más de 50,000 nuevos casos de cáncer de tiroides, lo que representa aproximadamente el 3% de los nuevos casos de cáncer en los EUA.

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉Biopsy results of thyroid nodules are typically reported as 1 of 6 categories.

👉Each category carries a different risk of cancer.

👉Your Head and Neck Surgeon, specialist in thyroid cancer will help you interpret the results – Dr. ARRANGOIZ

👉Los resultados de la biopsia de los nódulos tiroideos se informan típicamente como 1 de 6 categorías.
👉Cada categoría conlleva un riesgo diferente de cáncer.
👉Su cirujano de cabeza y cuello, especialista en cáncer de tiroides, lo ayudará a interpretar los resultados - Dr. ARRANGOIZ

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉Thyroid cancer can occur at any age but is most commonly diagnosed between ages 35 to 65. (source: https://seer.cancer.gov)

👉El cáncer de tiroides puede ocurrir a cualquier edad, pero se diagnostica con mayor frecuencia entre las edades de 35 a 65 años. (Fuente: https://seer.cancer.gov)

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉The National Surgical Adjuvant Bowel and Breast Project B-18 was designed to determine whether preoperative chemotherapy would result in improved survival compared to postoperative chemotherapy.

👉Secondary aims included evaluation of pathological complete response (pCR) rates and comparison of breast conservation rates and ipsilateral recurrence rates between the two groups.

👉Between 1988 and 1993, 1523 patients with clinical T1-3 N0-1 operable breast cancer were enrolled in the trial; 763 were randomized to preoperative therapy while 760 were randomized to postoperative therapy.

👉At 16 years of follow-up, there was no difference in disease-free survival (HR = 0.93, 95% CI, 0.81 to 1.06, p = 0.27) or overall survival (HR = 0.99, 95% CI, 0.85 to 1.16, p = 0.90) between the postoperative and preoperative chemotherapy groups.

👉In the preoperative group, a pCR was documented in 13% of patients.

👉Preoperative chemotherapy patients had a significantly increased incidence of having pathologically negative nodes compared to postoperative chemotherapy patients (58% vs. 42%, respectively; p<0.0001).

👉The rate of breast conservation was higher among women who received neoadjuvant chemotherapy compared to women who received postoperative chemotherapy (68% versus 60%, respectively; p = 0.001).

– The significant downstaging of tumors greater than 5cm in size in the preoperative chemotherapy arm primarily drove this breast conservation trend.

👉There was a trend toward a higher rate of ipsilateral breast tumor recurrence with preoperative vs postoperative chemotherapy (13% of 506 patients vs 10% of 450 patients, respectively), although this difference was not statistically significant (p = 0.21).

👉Retrospective series later found no difference in surgical complications between women who received preoperative or postoperative chemotherapy.

👉References:

1. Fisher B, Bryant J, Wolmark N, et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998;16(8):2672-2685.
2. Boughey JC, Peitinger F, Meric-Bernstam F, et al. Impact of preoperative versus postoperative chemotherapy on the extent and number of surgical procedures in patients treated in randomized clinical trials for breast cancer. Ann Surg. 2006;244(3):464–470.
3. Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol. 2008;26(5):778-785.

👉Starting in October (Breast Cancer Awareness Month) Rodrigo Arrangoiz MS, MD, FACS member of Sociedad Quirúrgica S.C. will be writing daily post on breast diseases.

 👉A partir de octubre (Mes de concientización sobre el cáncer de mama), Rodrigo Arrangoiz MS, MD, miembro de FACS de la Sociedad Quirúrgica S.C., escribirá una publicación diaria sobre enfermedades de la mama

👉Rodrigo Arrangoiz MS, MD, FACS is surgical oncologist / breast cancer specialist and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:

👉Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

For more information visit: http://www.cirugiatiroides.com

#Arrangoiz

#Teacher

#Surgeon

#Cirujano

#BreastExpert

#BreastSurgeon

#CirujanodeMama

#ExpertoenCancerdeMama

#CancerdeMama

#SurgicalOncologist

#CirujanoOncologo

#CancerSurgeon

• Estimated new cases of thyroid cancer in 2019:52, 070 cases3% of all new cancer cases reported in the United States
• Estimated deaths from thyroid cancer in 2019:2,170 deaths0.4% of all cancer deaths in the United States 
• Number of New Cases and Deaths per 100,000 individual:The number of new cases of thyroid cancer:Was 15.8 per 100,000 men and women per yearThe number of deaths:Was 0.5 per 100,000 men and women per year:These rates are age-adjusted and based on 2012 to 2016 cases and deaths.
• Lifetime Risk of Developing Thyroid Cancer: Approximately 1.3% of men and women will be diagnosed with thyroid cancer at some point during their lifetime:Based on 2014 to 2016 data.
• Prevalence of Thyroid Cancer: In 2016:There were an estimated 822,242 people living with thyroid cancer in the United States.

• How Many People Survive Five-Years Or More after Being Diagnosed with Thyroid Cancer?98.2% of patients diagnosed with thyroid cancer will be alive at 5-years:Relative survival statistics:Compare the survival of patients diagnosed with cancer with the survival of people in the general population who are the same age, race, and gender and who have not been diagnosed with cancer.
  • • • Because survival statistics are based on large groups of people, they cannot be used to predict exactly what will happen to an individual patient:No two patients are entirely alike, and treatment and responses to treatment can vary greatly.

• Survival by Stage:
  • Cancer stage at diagnosis:
    • Which refers to extent of a cancer in the body:Determines treatment options and has a strong influence on the length of survival.
      • In general, if the cancer is found only in the part of the body where it started it is:
        • Localized (sometimes referred to as stage 1).
      • If it has spread to a different part of the body:
        • The stage is regional or distant.
    • The earlier thyroid cancer is caught:
      • The better chance a person has of surviving five years after being diagnosed:
        • For thyroid cancer:
          • 67.0% are diagnosed at the local stage:The 5-year survival for localized thyroid cancer is:
            • • 99.9%
          • 27% are diagnosed with regional lymph node metastasis:
            • The 5-year survival for thyroid cancer with regional metastasis is:
              • 98.2%
          • 4% are diagnosed with distant metastasis:
            • The 5-year survival for metastatic thyroid cancer is:
              • 58.2%

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

Check out these recently published thyroid-related articles!

Should total thyroidectomies be performed by high-volume endocrine surgeons? A cost-effectiveness analysis. Anagnostis P, Pliakos I, Panidis S, Chorti A, Stelmach V, Michalopoulos A, Papavramidis TS.

Endocrine. 2019 Sep 20. PMID: 31541389 https://www.ncbi.nlm.nih.gov/pubmed/31541389

Characterization of Thyroid Cancer Driven by Known and Novel ALK Fusions. Panebianco F, Nikitski AV, Nikiforova M, Kaya C, Yip L, Condello V, Wald AI, Nikiforov YE, Chiosea SI. Endocr Relat Cancer. 2019 Sep 1. PMID: 31539879 https://www.ncbi.nlm.nih.gov/pubmed/31539879

Selective use of Molecular Testing Based on Sonographic Features of Cytologically Indeterminate Thyroid Nodules: A Decision Analysis. Zanocco KA, Wang MM, Yeh MW, Livhits MJ. World J Surg. 2019 Sep 19.

PMID: 31538250 https://www.ncbi.nlm.nih.gov/

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉As part of routine surveillance of patients diagnosed with breast cancer, the following is recommended according to the NCCN guidelines:

• History and physical exam 1-4 times per year, as clinically appropriate, for 5 years, and then annually
• Educate, monitor, and refer for lymphedema management
• Mammography every year
• In the absence of symptoms, there is no evidence to support laboratory or imaging studies for metastatic screening
• Women on tamoxifen should have annual gynecologic screening
• Women on aromatase inhibitor therapy should have monitoring of bone health and density at baseline and periodically thereafter
• Assess and encourage adherence to adjuvant endocrine therapy
• Evidence suggests that active lifestyle and achieving and maintaining an ideal body weight (20-25 BMI) may lead to optimal breast cancer outcomes

👉Como parte de la vigilancia / seguimiento de rutina de pacientes que fueron diagnosticados con cáncer de mama, se recomienda lo siguiente de acuerdo con las pautas de NCCN:
Historia y examen físico 1-4 veces al año, según sea clínicamente apropiado, durante 5 años, y luego anualmente
Educar, monitorear y derivar para el manejo del linfedema
Mamografía cada año
En ausencia de síntomas, no hay evidencia que respalde los estudios de laboratorio o de imágenes para descartar enfermedad metastástatica
Las mujeres que toman tamoxifeno deben hacerse un examen ginecológico anual
Las mujeres que reciben terapia con inhibidores de la aromatasa deben valorar la salud ósea y la densidad ósea al inicio y periódicamente a partir del inicio del tratamiento.
Evaluar y fomentar la adherencia a la terapia endocrina adyuvante.
La evidencia sugiere que un estilo de vida activo y lograr y mantener un peso corporal ideal (20-25 IMC) puede conducir a resultados óptimos de cáncer de mama

👉Starting in October (Breast Cancer Awareness Month) Rodrigo Arrangoiz MS, MD, FACS member of Sociedad Quirúrgica S.C. will be writing daily post on breast diseases. 

👉 A partir de octubre (Mes de concientización sobre el cáncer de mama), Rodrigo Arrangoiz MS, MD, miembro de FACS de la Sociedad Quirúrgica S.C., escribirá una publicación diaria sobre enfermedades de la mama

Rodrigo Arrangoiz MS, MD, FACS is surgical oncologist / breast cancer specialist and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

For more information visit: http://www.cirugiatiroides.com

#Arrangoiz

#Teacher

#Surgeon

#Cirujano

#BreastExpert

#BreastSurgeon

#CirujanodeMama

#ExpertoenCancerdeMama

#CancerdeMama

#SurgicalOncologist

#CirujanoOncologo

#CancerSurgeon

👉Check out these recently published Thyroid-related articles!

A comparative cost-utility analysis of postoperative calcium supplementation strategies used in the current management of hypocalcemia. Nicholson KJ, Smith KJ, McCoy KL, Carty SE, Yip L. Surgery. 2019 Sep 9. PMID: 31515122 https://www.ncbi.nlm.nih.gov/pubmed/31515122

Early postoperative stimulated serum thyroglobulin quantifies risk of recurrence in papillary thyroid cancer. Jayasekara J, Jonker P, Lin JF, Engelsman AF, Wong MS, Kruijff S, Aniss A, Learoyd D, Bligh RC, Glover A, Delbridge L, Sidhu S, Sywak M. Surgery. 2019 Sep 9. PMID: 31515121 https://www.ncbi.nlm.nih.gov/pubmed/31515121

Immunomorphological Pattern of Molecular Chaperones in Normal and Pathological Thyroid Tissues and Circulating Exosomes: Potential Use in Clinics. Caruso Bavisotto C, Cipolla C, Graceffa G, Barone R, Bucchieri F, Bulone D, Cabibi D, Campanella C, Marino Gammazza A, Pitruzzella A, Porcasi R, San Biagio PL, Tomasello G, Conway de Macario E, Macario AJL, Cappello F, Rappa F. Int J Mol Sci. 2019 Sep 11;20(18). PMID: 31514388 https://www.ncbi.nlm.nih.gov/pubmed/31514388

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉Follow-up after surgery for thyroid cancer larger than 1cm usually involves a physical exam, monitoring labs for thyroid hormone (TSH) and thyroglobulin levels, and ultrasound of the neck at regular intervals.

• Es pionero en México de la:
  • Cirugia tiroidea minimamente invasiva
  • La cirugia minimamente invasiva radio-guiada de paratiroides

•  Su entrenamiento es el siguiente:
  • Tumores de Cabeza y Cuello / Cirugía Endocrina – Fox Chase Cancer Center

• Tumores de Cabeza y Cuello / Cirugía Endocrina – IFHNOS / Memorial Sloan Kettering Cancer Center

👉Check out this recently published Parathyroid-related article!

👉Autofluorescence imaging of parathyroid glands: An assessment of potential indications. Kose E, Rudin AV, Kahramangil B, Moore E, Aydin H, Donmez M, Krishnamurthy V, Siperstein A, Berber E. Surgery. 2019 Sep 13. PMID: 31526579 https://www.ncbi.nlm.nih.gov/pubmed/31526579

Rodrigo Arrangoiz MS, MD, FACS cirujano de tumores de cabeza y cuello / cirugia endocrina es experto en el manejo del hiperparatiroidismo primario.

Introdujo a nuestro país la técnica de exploración bilateral de cuello con valoración de la funcionalidad de las glándulas paratiroides con paratiroidectomia radioguiada:

https://m.youtube.com/watch?v=AgvQmtz1gnA&time_continue=127

Su entrenamiento fue el siguiente:

• Cirugia general y gastrointestinal:
• Michigan State University:
• 2004 al 2010• Cirugia oncológica / tumores de cabeza y cuello / cirugia endocrina:
• Fox Chase Cancer Center (Filadelfia):
• 2010 al 2012• Maestria en ciencias (Clinical research for healthprofessionals):
• Drexel University (Filadelfia):
• 2010 al 2012• Cirugia de tumores de cabeza y cuello / cirugiaendocrina
• IFHNOS / Memorial Sloan Kettering Cancer Center:
• 2014 al 2016

http://www.sociedadquirurgica.com

http://www.hiperparatiroidismo.info

#Arrangoiz

#CirugiadeTumoresdeCabezayCuello

#CirugiaEndocrina

#CirugiaOncologica

#HeadandNeckSurgery

#EndocrineSurgery

#SurgicalOncology

#Hyperparathyroidism

#Hiperparatiroidismo