Andrew Pieri

The Newcastle upon Tyne Hospitals NHS Foundation Trust · Department of Surgery

Objective: A new configuration of closed incision negative pressure therapy (ciNPT) dressings now covers the incision and a broader area of peri-incisional tissues. We have implemented these ciNPT dressings following simple mastectomy (SM) or skin-sparing mastectomy with implant-based reconstruction (IBR). This study assesses patient-reported outc...

Purpose While it is known that histologically involved margins lead to a higher local recurrence rate, re-excision of anterior margins is less common than that of radial margins. However, there are minimal long-term data on the oncological safety of non-surgical management of anterior margins. Patients and methods A retrospective study was perform...

Background: In the UK, guidewires have traditionally been used for localisation of non-palpable breast lesions in patients undergoing breast conservation surgery (BCS). Radioactive Seed Localisation (RSL) using Iodine-125 seeds is an alternative localisation method and involves inserting a titanium capsule, containing radioactive Iodine-125, into...

Introduction: Radioactive seed localisation (RSL) has become increasingly popular for localisation of non-palpable breast tumours. This is largely due to advantages it offers in terms of practicality and convenience when compared to guide wire localisation (WL). This institute switched from using WL to RSL in September 2014. The primary aim was to...

Introduction The use of primary endocrine therapy (PET) in managing breast cancer in the elderly has become common practice. Whilst there appears to be no difference in overall survival in comparison with surgery, PET has been found to be inferior in local disease control with a limited duration of efficacy (2-3 years). The International Society of...

Aims In patients presenting with a breast lesion, when initial core biopsy histology falls into the category of “uncertain malignant potential” (i.e. a B3 lesion), the next line of investigation has traditionally been a surgical biopsy (SBx). Vacuum-assisted biopsy (VAB) may be a viable minimally invasive alternative to SBx for B3 lesions. The prim...

Background: Acellular dermal matrices (ADM) such as Strattice(TM) are increasingly used in UK during implant-based reconstruction. However, there are mixed opinions regarding the compatibility of radiotherapy treatment in pre- and post-reconstructed breasts. The aims of this study are to audit the rates of radiation induced complications in patien...

Breast cancer metastases occurs in around 50% of all presentation. It is the second most common type of cancer to metastasise to the GI tract but this only occurs in less than 1% of cases. We report a case that underwent treatment for invasive lobular cancer (ILC) of the breast and 5 years later was found to have rectal and peritoneal metastasis. S...

Aims: In patients presenting with a breast lesion, when initial core biopsy histology falls into the category of "uncertain malignant potential" (i.e. a B3 lesion), the next line of investigation has traditionally been a surgical biopsy (SBx). Vacuum-assisted biopsy (VAB) may be a viable minimally invasive alternative to SBx for B3 lesions. The pr...

Introduction Following a diagnosis of breast cancer, pre-operative ultrasound staging of the axilla is recommended. Patients found to have metastatic disease on biopsy or FNA can proceed directly to axillary clearance (ALNC) at the time of their breast tumour excision. However, although ultrasound staging is a sensitive test to detect axillary dise...

The clinical significance of pleomorphic lobular carcinoma in situ (PLCIS) is a subject of controversy. As a consequence, there is a risk of providing inconsistent management to patients presenting with PLCIS. This review aims to establish whether the current guidelines for the management of PLCIS are consistent with current evidence. A systematic...

Temporal artery biopsy (TAB) is the gold standard for diagnosing temporal arteritis; however, sensitivity is relatively poor (30-40 per cent). The British Society of Rheumatology (BSR) guidelines state two major factors that can improve sensitivity: TAB specimen size > 10mm; and pre-biopsy steroid treatment < 7 days. Owing to the low sensitivity, T...

Objective: Recent studies have investigated visual analogue scales (VAS) as an alternative to the Lake Louise AMS Self-Report Score (LLS) for the self-assessment of acute mountain sickness (AMS). We investigated their use in adolescents. Methods: The study was conducted during the 2009 and 2010 British Schools Exploring Society 35-day expedition...

The object of this study was to examine if there exists, analogously to what happens in human cancer patients, elevation of phosphohexose isomerase activity (PHI, EC 5.3.1.9) in the serum of animals bearing an experimental tumor and, if so, whether such increases were related to the progress of the tumor, as in humans. The behavior of the same enzy...