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Giuliana Caprio

Publications and source records attributed to Giuliana Caprio.

6 recordsLinked to original sources

A phase II trial of a biweekly combination of paclitaxel and gemcitabine in metastatic breast cancer.

BACKGROUND: Many emerging new drugs have recently been trialled for treatment of early and advanced breast cancer. Among these new agents paclitaxel and gemcitabine play a crucial role, mostly in patients with relapsed and metastatic disease after failure of chemotherapy with antracyclines. METHODS: A phase II study was started in order to evaluate the activity and toxicity of a combination of paclitaxel and gemcitabine in a biweekly schedule on metastatic breast cancer patients previously treated with antracyclines. RESULTS: Twenty-five patients received paclitaxel (150 mg/mq) by 3-hours infusion, followed by gemcitabine (2000 mg/mq) given as a 60 min i.v. infusion (day 1-14) for a maximum of eight cycles. In all patients treatment was evaluated for toxicity and efficacy; four patients (16%) achieved a complete response, 12 (48%) a partial response giving an overall objective response rate of 64%. Stable disease was documented in 5 patients (20%) and progressive disease occurred in 4 patients (16%). CONCLUSION: The schedule of treatment was safe and tolerable from a haematological and non-haematological point of view. These data confirm that the combination of gemcitabine and paclitaxel on a biweekly basis is an effective and well-tolerated regimen in breast cancer patients with prior therapeutic exposure to antracyclines.

Adult↗

[Breast carcinoma in young women].

Breast cancer presents important differences in distribution of histopathologic factors between younger and older patients but it's less clear if reduction of survival which often occurs in cancer of the youth depends on the concomitant presence of negative prognostic factor or if age alone acts as a factor indicating more aggressiveness. Many studies seem to indicate that young age at diagnosis is an independent predictive factor mostly in patients with early stage of disease and negative nodes. Other studies assert that age can be considered as the most important predictive factor after nodes involvement.

Age Factors↗

[Day surgery in a multidisciplinary breast unit].

The most recent studies on breast surgery have led us to radio-guided surgery which enables us to identify the sentinel lymph node and thus to remove just a single lymph node. As a result, we are moving in the direction of an increasingly conservative surgical technique which may be carried out in the day surgery setting. This kind of surgery requires both an extremely accurate and prompt diagnosis and a multidisciplinary breast unit, inasmuch as only the collaboration and teamwork of highly qualified staff are capable of furnishing a rapid, accurate diagnosis; in addition, during the operation it may be necessary to perform x-rays or ultrasonography on the surgical specimen. Obviously, nuclear medicine is essential for radio-guided surgery. We report here on our experience with 36,000 women with 1,147 carcinomas whose diameters were less than or equal to 2 cm in 78.64% of the cases, with the possibility of performing conservative surgery in such cases. Moreover, by way of confirmation of the good diagnostic accuracy, we report our findings in 954 lesions operated on under local anaesthesia, because they were presumed to be most probably or definitely benign, but which tended to increase in volume. During the final histological examination only 10 of these 954 lesions turned out to be malignant, with only a 1.05% incidence of diagnostic error.

Adult↗

One-day surgery in a series of 150 breast cancer patients: efficacy and cost-benefit analysis.

Financing health-care expenditure has become increasingly more difficult. Considering the high frequency of breast cancer, which affects one million women in the world each year, the reductions of medical expenditure for the treatment of this disease is highly desirable within the limits of medical efficiency and safety. One hundred and fifty patients with carcinoma of the breast underwent surgery in our department with one-day hospitalization. Patients were discharged with the drainage tube still in place and later treated in the out-patient setting, for dressing and checking the wound, and removing the stitches and drainage tube. Four cases of seroma were registered, all resolved by aspiration of the fluid in a single visit, 1 case of haematoma and 1 case of infection. Patients who underwent this short-stay treatment were amply satisfied. Our experience demonstrates that this type of treatment is both safe and effective. Moreover, it provides considerable benefits in terms of national health-care costs as well as being psychologically better for the patients.

Adult↗

[Diagnosis and treatment of fibroadenoma of the breast: 20 years' experience].

The diagnostic differentiation of breast lesions is very important because of the frequency with which they occur. Though fibroadenoma is easy to diagnose, some cases prove really hard to distinguish. Therefore, various methods have been suggested both for diagnosis and therapy, but no common approach has been achieved to date. We report our experience with 1350 cases diagnosed over a twenty-year period. The diagnosis was made on the basis of a diagnostic protocol drawn up over the years where cytology is of primary importance. With regard to therapy, we decide to operate when the cytological findings prompt the need for a histological examination of the lesion. Moreover, we operate on those cases where either an increase in size or a morphological change of the lesion has taken place. Histological examinations were carried out in 420 cases out of 1350 and only one of these cases turned out to be a carcinoma. As a result, the 0.24% error in the diagnosis can be considered irrelevant. In spite of the different therapies suggested (cryoablation, laser hyperthermia, i.a.), we believe that surgical treatment with local anaesthetic is the most suitable solution in those cases requiring treatment. Obviously, the diagnosis has to be accurate and made by surgeons with appropriate expertise. When the diagnosis is certain and the conditions of the lesion are stable, the best policy seems to be periodic follow-up.

Adult↗