Primary breast cancer treatments: a locoregional recurrence review.
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Breast Neoplasms↗
Biomedical subjects
G Andry
Publications and source records attributed to G Andry.
Sentinel lymph node evaluation in squamous cell carcinoma of the head and neck cancer: preliminary results.
INTRODUCTION: Sentinel lymph node biopsy is a new technique in staging the clinically NO neck. Tumour spread to the neck is the most important prognostic factor in head and neck squamous cell carcinoma (HNSCC). MATERIAL AND METHODS: Patients with histologically confirmed HNSCC, with no clinical and no radiological (CT or MRI) evidence of cervical lymph node involvement were eligible for this prospective study. The lymph node mapping was performed by preoperative lymphoscintigraphy and intraoperative use of hand-held gamma probe. Four injections (with Tc 99m-labeled nanocolloids) were performed around the primary tumour. The SLN, as indicated by dynamic scintigraphy and the neck dissection specimen, were sent separately for histological analysis. The presence of occult metastasis in the SLN and in the neck dissection specimen were compared. RESULTS: Ten consecutive patients (8 males ; 2 females) with a mean age of 61 years (range 47 to 74 years) were prospectively entered into the study. The primary tumour was located on the oral tongue in 4 cases, in the floor of the mouth in 5 cases and in the oropharynx in 1 case. Primary tumours were staged T2 in nine cases, one tumour was staged T1 according to UICC 1997. All the tumours were clinically staged cN0 by palpation and computed tomography (or MRI). Lymphoscintigraphy was performed and revealed a SLN in all cases. The sentinel node biopsy technique permitted an upstaging of the clinically cN0 neck in 3/10 cases. The SLN technique was false negative in one patient with a skip metastasis. CONCLUSION: SLN evaluation in HNSCC is feasible and provides a highly accurate staging of NO necks in oral and oropharyngeal carcinomas.
Aged↗
Metastatic involvement of ceco-appendicular segment: a diagnosis of right lower quadrant abdominal pain in patient receiving chemotherapy.
Metastases are a common feature during the evolution of breast cancer. However, gastrointestinal metastases, and especially ceco-appendicular ones, are very rare. Melanoma however frequently metastasize in the gastrointestinal tract. Ceco-appendicular metastases do not display any specific signs in cancerous patients. These rare metastases must be considered in the diagnosis of right lower quadrant pain in cancerous patients. The main differential diagnosis includes neutropenic enterocolitis, acute appendicitis, malignant intestinal obstruction and perforation of the bowel. The morbidity of gastrointestinal complications in patients with metastatic cancer receiving chemotherapy is significant and surgery is often the only chance of survival. The major clinical decision is whether or not to operate.
Abdominal Pain↗
Thyroid carcinoma metastasis to the sternum: resection and reconstruction.
Metastases of thyroid carcinoma to the sternum are not so frequent and ablative surgery enables the patients to live longer with a better quality of life. After such a resection, the surgical defect has to be covered either by autogenous or artificial substitutes. We present a 62 years old patient with an asymptomatic sternal metastasis of a poorly differentiated follicular thyroid carcinoma. After radical excision, including the sternum, both clavicular heads and an upper mediastinal dissection, the defect was reconstructed in two layers, combining a Marlex mesh and a pedicled pectoralis major muscle flap. Postoperative course was uneventful and respiratory function was not disturbed.
Carcinoma↗
[The so-called minimal cancers of the breast (author's transl)].
In situ lobular carcinoma, intraductal carcinoma and papilliferous non-invasive carcinoma are three non-invading cancers that present clinically as the other malignant tumors of the breast. Between January 1, 1973 and August 31, 1976, ten patients were operated at the institut Bordet for such tumors. Surgical treatment varied between radical mastectomy according to Madden and partial mammectomy. Follow-up reveals no recurrence over periods extending from zero to three years. The choice of treatment depends on the histology and the probability of evolution of the actual cancer.
Breast Neoplasms↗
[Microsurgery and free flaps as indications for the reconstruction of the mouth and pharynx region following tumor resection].
This article describes the microsurgical approach of the head and neck team of the Bordet Institute. During a period of 2 1/2 years 35 free flaps, 71 Pectoralis Major and 9 local flaps were performed for oropharyngeal reconstruction. Different types of free flaps were used and analyzed: 15 latissimus dorsi myocutaneous, 8 radial forearm, 1 gastric, 3 jejunum, 2 crista iliaca osteocutaneous, 1 scapular osteomyocutaneous, 3 scapular osteo-muscular of a new type (discovered in our department), 1 serratus anterior muscular and 1 flap composed of 3 others (a latissimus myocutaneous, a serratus anterior and a scapular osteo-muscular flap). 60% of the microvascular anastomoses were performed in a previously heavily irradiated area and none failed. The indications of some of these flaps are discussed and summarized.
Bone Transplantation↗
[Lymphedema after modified radical mastectomy as performed at the Bordet Institute. A report of 60 cases (author's transl)].
Three hundred and fifteen patients who underwent a radical mastectomy between 1969 and 1976 were studied. Nineteen percent developed lymphedema of the upper limb. Ten percent were resistant to all forms of therapy while the pathology gradually subsided in 9%. The causes of lymphedema as well as the preventive and curative methods were statistically studied and compared with those in the literature. Several preventive measures are proposed, in particular, the modified radical mastectomy.
Female↗
[Intrathyroid metastasis. Anatomo-clinical problem].
The authors are describing a case of clear cell renal epithelioma metastasizing in the thyroid gland; the clinical course and the histological appearance were consistent with a primary carcinoma of the thyroid gland of the undifferentiated large cell type.
Adenocarcinoma↗
[Diagnosis and surgical treatment of metastatic cervical adenopathies].
Needle biopsy is preferable to open biopsy for several reasons; no tumor spread, no inconvenient scars hampering future surgical intervention, no delay between diagnostic procedure and definitive therapy as well as its simplicity. A conclusive histological diagnosis of malignancy is only made in 70 to 80% of the cases by this technic. In the other cases however, the macroscopic and microscopic aspect usually very strongly suggests the nature of the disease. When a definite diagnosis of malignancy cannot be made this way an open biopsy is mandatory and to be performed under general anesthesia by a surgeon who is able to proceed immediately with the appropriate surgical therapy as soon as a peroperatory positive histological diagnosis is obtained. The classical therapy consists of a unilateral or bilateral radical neck dissection with or without resection of the primary tumor. The postoperative follow-up is usually simple. The incidence of postoperative complications is higher when the cervical region has been irradiated with a dose equal or higher to 5,500 tumor rads or when the larynx, pharynx and/or buccal cavity have been entered.
Biopsy↗
[1- or 2-stage bilateral radical neck dissection].
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Adult↗
The Belgian and European Thyroid Cancer Registry. Belgian Thyroid Cancer Study Group.
Thyroid cancers frequently have a good prognosis, most of the patients are young and have a long life expectancy. Several hundreds of cases have to be observed over two to five decades before establishing studies of significant actuarial survival and determining the initial prognostic factors likely to characterize the disease. These elements necessitate the creation of a thyroid cancer registry gathering together, from several centres, the data and allowing a computerized multifactorial analysis. Each hospital will have the possibility to participate, with the help of the Belgian Campaign against Cancer, by means of a simple computerized system. Pathologists, endocrinologists, radiologists, radioisotope specialists and surgeons will coordinate their efforts to supply the necessary data to epidemiologists, statisticians and fundamental-researchers. Substantial progress can be expected providing all agree to an individual and collective effort which will have beneficial repercussions on the quality of patient care and the progress of knowledge. The Belgian Thyroid Cancer Study Group will permit our national medicine to meet the European requirements in this regard.
Adult↗
[Modified radical mastectomy. Experience of the Institut J. Bordet (author's transl)].
The authors report the results of a homogeneous series of 319 modified radical mastectomies where both pectoralis muscles are respected, in the treatment of breast cancer. Operative mortality is nill and morbidity is low. Persistant lymphedema of the arm is not marked. The frequency of axillary nodes is 64%. Local recurrences occur in 12% of cases. Total 5 year survival was 50.1%. It was 89% for stage I, 57.3% for stage II and 43.7% for stage 222. It was 61.5% if there were no involved nodes, 63.9% when 1 to 3 nodes were involved and 32% when 4 or more nodes were involved. The authors recommend this type of operation of tumors of state II and III as the 5 year survival is identical to that of other techniques, as morbidity and mortality are low and distant sequellae are unimportant.
Adult↗
[Ulcer of the rectum: problem of diagnosis and therapy. Case report (author's transl)].
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Agranulocytosis↗