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G Contesso

Publications and source records attributed to G Contesso.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Hyperplastic lesions of the high risk breast. Definitions, diagnostic and therapeutic problems].

It has become possible to select from the framework of those women who have epithelial proliferations a group that are at high risk. This has been achieved by bringing together methods employed in the fields of defining better what are lesions of the breast, in assessing what are the best ways early detection of cancer of the breast and in epidemiological researches. The precise significance of these lesions in the absence of sufficiently reliable biological parameters is still problematic and their future still uncertain. Their relationship to invasive cancer is far from being constant, but it is possible for them to regress spontaneously. There are still limits between the results obtained in experimental animals and in human beings but as yet there has been no medical treatment that can be claimed to be a certain way of avoiding proliferative activity in these mastopathies. Surgery is also often poorly adapted to this kind of situation. In view of this, the choice of therapy is often difficult and has to be tailored to each case.

Biopsy↗
PubMed1992

[Elastofibroma dorsi. Apropos of 5 cases].

Elastofibroma is a rare tumor mainly found under the scapula. Based on a recent study of five cases, we would like to stress the importance of making the diagnosis of elastofibroma, as this lesion simply consists of dysplasia of the elastic fibres and is not malignant as could be suggested by clinical examination.

Aged↗
PubMed1992

Adjuvant CMF for node-negative and estrogen receptor-negative breast cancer patients.

From December 1980 to September 1985, a total of 90 eligible patients with stage T1-3a, node-negative, and estrogen receptor-negative (less than or equal to 10 fmol/mg of cytosol protein) tumors were entered into a randomized study to assess the effectiveness of adjuvant intravenous (IV) cyclophosphamide, methotrexate, and fluorouracil (CMF) in a subset of patients at high risk of early disease relapse. High values of [3H]thymidine labeling index were documented in two thirds of 62 assessed specimens from the patient population, and one half of the patients had histologically undifferentiated tumors. Patients were allocated to either local-regional modality alone (control group, 45 women) or to CMF (45 patients) after surgery. A full dose of CMF (600 mg/m2 each of cyclophosphamide and fluorouracil, and 40 mg/m2 of methotrexate) was administered IV on day 1, and then repeated every 3 weeks for a total of 12 treatments. After a median follow-up of 80 months, the 7-year results confirmed the superiority of adjuvant CMF compared to local-regional modality alone (relapse-free survival 85% vs 42%, P = .0001; total survival 86% vs 58%, P = .006). A benefit from adjuvant CMF was observed in all subgroups, and the rates of both local-regional and distant failure were decreased. Treatment was fairly well tolerated and devoid of life-threatening toxicity. Present results confirm our previous observation concerning the dismal prognosis of node-negative and estrogen receptor-negative breast cancer patients as well as the beneficial effect of adjuvant chemotherapy in this selected subset.

Adult↗
PubMed1991

[Metastases from cancers of unknown primary site. Data from 302 autopsies].

The autopsies of 302 patients who had metastases from cancers of unknown primary site were studied. In two-thirds of the cases the metastases were located in the lymph nodes, the lungs and the bones. The primary tumour was found in 82 patients when still alive (27 percent) and in 173 patients (57 percent) at autopsy. It could not be identified in 16 percent of the cases. The primary tumours most often discovered were in the pancreas (26.5 percent), the lungs (17.2 percent), the kidneys (4.6 percent) and the colorectal bowel (3.6 percent). On the whole, the paraclinical examinations performed for diagnostic purposes had been disappointing. The survival rate was the same whether or not the primary tumour had been identified. The number of inaugural metastases seems to be a major prognostic factor. These highly progressive tumours must represent a very distinct clinical and biological neoplastic entity. A simple approach and a unicist practical management are suggested.

Adolescent↗
PubMed1991

Twenty years experience of interstitial iridium brachytherapy in the management of soft tissue sarcomas.

From February 1968 to February 1988, 50 patients above 10 years of age with a soft tissue sarcoma were treated with interstitial brachytherapy, combined with a wide excision. After pathologic review, 48 were included in the final analysis. A pathological grading was made possible in 41, which showed a majority of high grades (2 + 3 = 86%). Patients presented mainly with small (less than 5 cm: 36) or mid-size lesions (greater than 5 cm: 12). The tumor was located in the limbs (32), trunk (9), and head and neck (7). Four patients had metastases at the time of treatment. Brachytherapy was part of the initial treatment in 22 cases, and of a salvage procedure after previous excision(s) combined or not with another form of treatment in 26. A uniform technique of iridium 192 wires after-loaded in plastic tubing was used. Sixty Gy median doses were delivered with brachytherapy alone (44) or combined with external beam (4). Sixteen patients also received an adjuvant chemotherapy. Follow up ranged from 16 months to 20 years (median 82 months). At the time of analysis, two patients (4%) only had failed in the irradiated volume, but the marginal failures rate (14:31%) was unexpectedly high. Seven of the patients who failed (43%) were salvaged by a second similar procedure. The 5-year survival was 62% in non-previously treated patients and 56.5% in previously treated ones (pNS). By multivariate analysis, only the tumor location appeared predictive of LF (p less than 0.01), which in turn was strongly correlated with the metastatic outcome (p less than 0.01). Necroses were observed in 17 cases (35%) and associated with a benign course in most of them. High dose brachytherapy combined with conservative surgery is highly effective in small and mid-size soft tissue sarcomas located in the extremities and head and neck, whereas in trunk and in recurrent tumors, the adjunction of large fields external radiotherapy and/or possibly polychemotherapy appears necessary.

Adolescent↗
PubMed1991

[Diagnosis of local recurrence after conservative treatment of breast cancer. A comparative study of a series of 50 cases].

In order to determine the diagnostic features of recurrences after conservative treatment of breast cancer, 100 files have been studied. Fifty cases of glandular recurrence have been analysed and compared to 50 control cases of same stage, age and follow-up, without recurrence. In 58% of cases, the diagnosis was established during the course of a visit requested by the patient. In 84% of the cases the recurrence was found to be within the tumorectomy zone. The significant glandular pains, mammary density and deformation, nipple retractions and the radiological evidence of microcalcifications and irregular opacities seem to be strongly indicative of recurrence. The simultaneous clinical and radiological expression of recurrence was not noted in more than 52% of cases.

Breast Neoplasms↗
PubMed1991

[When must a mastopathy at risk be operated on? The viewpoint of the clinician, the radiologist, the surgeon, and the anatomopathologist].

The mastopathy is said to be truly "at risk" only when an anatomopathological examination has singled out certain criteria. At present, there is no medical treatment, particularly a hormonal one, capable of preventing the evolution towards a breast cancer. The indication for an operation could be based on a real score taking into account the age, the family history, the pregnancies, the fatness, the endogenous hormonal balance and the exogenous hormonal supply. In fact, above all considerations is the local mammary state, "the major mastoses", where a joint analytical study of: the clinical state, the mammography, the thermography and the cytopuncture is essential. The possibility of carrying out micro-biopsies under local anaesthesia is also underlined. Finally, we retain two big types of indication: of necessity. A lesion for which a doubt exists must be operated upon. The radiological location constitutes a considerable progress. Of principle. Namely in women with a heavy family history of breast cancer, a fortiori if the mammographies reveal dense, heterogeneous aspects, difficult to follow. Finally, the women for whom a previous biopsy has revealed lesions with an evolution potential (lobe neoplasia, extensive atypical epitheliosis). In conclusion, the indications are not often easy and is usually the object of a study of each case individually.

Adult↗
PubMed1991

[What is "mastopathy at risk" for the anatomopathologist?].

For the pathologist, the term "mastopathy at risk" comprises a double aspect. On one hand, a good definition of the boundary between benign lesions and cancer. The latter uses mainly, and still now, morphological signs, and no "markers" enable an infallible differentiation. Certainly certain criteria are useful observations to distinguish between intra-canal and intralobular epithelial hyperplasia of the carcinomas in situ, or to recognize between a tubular carcinoma and certain adenosis foci. But it is often the pathologist's experience which makes the difference. On the other hand, a good knowledge of the epidemiological studies associating, to each of the anatomopathological entities constituting the fibro-cystic mastopathy, a risk factor for breast cancer. Indeed, the pathologist must indicate, in his report, these various entities in order to help the clinician take his therapeutic decision. The results of the study of a population of 3,305 women who have been examined at the Gustave Roussy Institute between 1970 and 1973 for benign mammary lesions, 401 on whom a biopsy was carried out, will illustrate this observation, revealing the importance of multiple fibro-adenosis foci, small cysts and lobe hyperplasias. But the histological details of these benign mastopathies must imperatively be integrated to the epidemiological and clinical data on the patient in order to adapt the therapeutic protocol for the best.

Breast Diseases↗
PubMed1990

Can internal mammary chain treatment decrease the risk of death for patients with medial breast cancers and positive axillary lymph nodes?

The effect of internal mammary chain treatment on each type of malignant death-related event was analyzed in 1195 patients with operable breast cancer and histologically involved axillary lymph nodes. A group of 135 patients who had no internal mammary chain treatment was compared with a control group of 1060 patients who were treated by surgery and/or postoperative radiation therapy. In a multivariate analysis taking into account age, clinical size of the tumor, histoprognostic grading, and the number of positive axillary lymph nodes, quantitative interaction tests were used to determine whether the effects of internal mammary chain treatment on each type of malignant event were significantly different for patients with a lateral tumor compared with those with a medial tumor. The authors found that the effects of this treatment on the risks of distant metastases and of secondary breast cancer were not the same for the patients with a medial tumor as for those with a lateral tumor. For the untreated patients with a medial tumor, the risks of distant metastases and second breast cancer were, respectively, 1.6 (P = 0.02) and 2.9 (P = 0.02), compared with the treated patients. Conversely, for women with lateral tumor, no difference between the two treatment groups was observed. Thus, internal mammary chain treatment may improve long-term survival rate in patients with a medial tumor and positive axillary lymph nodes essentially by decreasing the risk of development of distant metastases (mainly brain, distant lymph nodes, multiple simultaneous metastases) and/or a secondary breast cancer.

Adenocarcinoma↗
PubMed1990

Immunohistochemical staining of bone marrow biopsies for detection of occult metastasis in breast cancer.

Immunohistochemical (IHC) techniques should allow for a greater detection of bone marrow micrometastasis in patients with breast carcinoma. We studied a series of bone marrow (BM) biopsies negative by conventional histologic techniques from 93 patients with breast carcinoma. Prior to this study, twelve BM biopsies, positive by conventional histology, were stained with a panel of monoclonal antibodies (MoAb), directed either against cytokeratin (KL1, AE1-AE3, CAM5-2) or epithelial membrane antigen (EMA, HMFG2). KL1 appeared to be the most sensitive of the markers used in the detection of metastases and is available commercially. It therefore was the only MoAb used with the series of 93 BM biopsies negative by conventional examination. Within this series, among 45 patients clinically suspected of having bone marrow metastasis but with BM biopsies negative by conventional staining, one case showing myelofibrosis stained positive with KL1 demonstrating isolated tumor cells. For the 48 patients without suspicion of bone marrow metastasis at initial diagnosis for breast carcinoma, KL1 revealed no marrow metastasis. Single bone marrow biopsy techniques whether stained by conventional or IHC methods do not appear to be useful tests to detect occult bone marrow metastasis, especially at initial diagnosis of clinically Mo breast carcinoma patients.

Antibodies, Monoclonal↗
PubMed1990

[The in vivo effect of the local administration of progesterone on the mitotic activity of human ductal breast tissue. Results of a pilot study].

Breast tissue samples were taken during surgery in premenopausal women with various benign breast diseases. Surgery was scheduled between day 11 to 13 of their menstrual cycle, before presumed ovulation and endogenous production of progesterone. Each patient was treated 11 to 13 days before surgery by daily percutaneous topical application on breast of either a placebo gel, a gel containing progesterone or a gel containing estradiol. Treatments were assigned at random and the study conducted double-blind. The mean estradiol concentration in breast tissue was significantly higher (3,409 pg/g) in the estrogen-treated group than in the placebo (365 pg/g) and the progesterone (523 pg/g) treated groups. The mean progesterone concentration in breast tissue was significantly higher (69.1 ng/g) in the progesterone treated group than in the placebo (1.95 ng/g) and the estradiol (3 ng/g) treated groups. Mitotic activity was calculated by counting with light microscopy mitoses in epithelial cells of normal lobular area. Mean mitotic activity was significantly lower in progesterone treated group (0.04/1,000 cells) than in placebo (0.10/1,000 cells) or in estradiol (0.22/1,000 cells) treated groups. High concentration of progesterone sustained in human breast tissue in vivo during 11 to 13 days does not increase, but actually decreases mitotic activity in normal lobular epithelial cells.

Administration, Cutaneous↗
PubMed1989

Primary breast sarcoma: a review of 33 cases with immunohistochemistry and prognostic factors.

The clinical and pathological features of 33 previously untreated patients with primary breast sarcoma were retrospectively analysed to evaluate the prognostic significance of histologic variables on survival. The series comprised 17 cystosarcomas phyllodes and 16 stromal sarcomas (excluding angiosarcomas). All tumors were reviewed and classified in similar fashion to extramammary soft tissue sarcomas. In addition, immunohistochemical studies were performed on paraffin sections with a panel of several antibodies directed against cytoskeletal filaments and cellular enzymes; five cases were also examined by electron microscopy. Most tumors were malignant fibrous histiocytoma (21 cases) and fibrosarcoma (6 cases) types. Surgery was the main therapy. Metastasis-free survival rate was significantly correlated only with histological grade, consisting of tumor differentiation, tumor necrosis, and mitotic activity. Courses and survivals of the cystosarcoma and stromal groups were identical, questioning the clinical value of this pathologic distinction. All local recurrence, metastasis, or death occurred within 30 months, though follow-up was much longer. Immunohistochemistry was disappointing for identification of specific histologic sub-types.

Adult↗
PubMed1989

Peripheral neuroectodermal sarcoma of soft tissue (peripheral neuroepithelioma): a pathologic study of ten cases with differential diagnosis regarding other small, round-cell sarcomas.

Peripheral neuroepithelioma of soft tissue belongs to the group of peripheral neuroectodermal tumors (PNETs), but because of its clinical, biological, and morphological characteristics, it differs from other small, round-cell sarcomas that appear in children (neuroblastoma) or in the thoracopulmonary region (Askin's tumor) and bone (peripheral neuroectodermal sarcoma of bone). We report ten new cases of such PNET variety, based on their histologic, immunohistochemical, and electron microscopic findings. In all of these cases, the clinicopathologic correlations demonstrated high malignancy, with an ominous outcome in nine cases. The mean age of the patients was 32.6 years and there was a clear male predominance (eight men, two women). Histologically, the presence of Homer-Wright rosettes is mandatory for diagnosis, being complemented with positive immunohistochemistry for several neural immunomarkers using paraffin-embedded material. Neuron-specific enolase, E-36, HNK-1, and chromogranin neural markers proved to be positive in a high number of cases, but other markers (S-100 protein, synapto-physin, GFA protein, and neurofilaments [70 kilodalton]) were absent. Electron microscopy confirmed the presence of neural structures, both by scanning and transmission electron microscopy.

Adolescent↗
PubMed1989

Ten-year results of a randomized trial comparing a conservative treatment to mastectomy in early breast cancer.

A randomized trial was conducted at the Institut Gustave-Roussy (IGR) between 1972 and 1980 comparing tumorectomy and breast irradiation with modified radical mastectomy. One hundred and seventy-nine patients with an infiltrating breast carcinoma up to 20 mm in diameter at macroscopic examination were included: 88 had conservative management, and 91 a mastectomy. All patients had a low-axillary dissection with immediate histological examination. For the patients with positive axillary nodes, a complete axillary dissection was undertaken. Overall survival, distant metastasis, contralateral breast cancer and locoregional recurrence rates were not significantly different between the two treatment groups.

Adenocarcinoma↗