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Biomedical subjects

J E Devitt

Publications and source records attributed to J E Devitt.

8 recordsLinked to original sources
PubMed1992

Risk of breast cancer in women with breast cysts.

OBJECTIVE: To study the occurrence of breast cancer in women with breast cysts. DESIGN: Prospective follow-up study. SETTING: Office surgical practice. PATIENTS: All 742 women referred to the practice with breast cysts diagnosed by means of aspiration or, occasionally, biopsy between 1969 and 1985. MAIN OUTCOME MEASURES: The incidence of breast cancer and the number of years between diagnosis of breast cyst and diagnosis of cancer. The observed number of cases of breast cancer was compared with the expected number, calculated from Ontario rates of breast cancer. RESULTS: Fifteen of the women died but did not have breast cancer. No follow-up information was available for five women. Another 38 were lost to follow-up; they did not have breast cancer at the last contact, after 2 to 17 years of follow-up. These patients were withdrawn from the study in the year in which they died or were last observed. By 1990, 34 (5%) of the women had breast cancer. The overall ratio of observed:expected cases of cancer was 3.04 (95% confidence interval 2.09 to 4.28). Breast cancer developed after 7.5 years, but the average length of follow-up was only 10.1 years. Only 3.8% of 374 women after 10 years and 5.4% of 141 women after 15 years had breast cancer. CONCLUSION: Women who have a gross breast cyst are at moderately increased risk of breast cancer, which usually develops only after many years.

Adolescent↗
PubMed1979

Mammography: a surgeon's experience.

Most reports advocating mammography have been written by radiologists rather than by clinicians who are frequently confronted by women with breast complaints. The value of mammography in managing patients with breast problems was studied by reviewing its role in 1026 breast consultations; there were 129 patients with cancer. Mammography was performed in 95 patients. The procedure hastened the diagnosis of one comedocarcinoma, and in another patient was suspicious 3 years before she presented with a locally advanced lesion. It missed six cancers. In seven patients it recognized clinically obvious cancers, though in one of these it had given negative results 10 months before the patient presented with a lesion 15 cm in diameter. It also falsely suggested the possibility of cancer in 28 women. In the other 52 patients the clinical diagnosis of a benign condition was usually fairly evident. The morbidity caused by mammography does not seem to have been widely appreciated, no doubt because of the hope that clinically unrecognized cancers would be found by it. Most breast problems can be diagnosed without mammography.

Attitude of Health Personnel↗
PubMed1979

Role of bilateral adrenalectomy (and oophorectomy) in the management of patients with metastatic breast cancer.

One hundred consecutive patients who underwent bilateral adrenalectomy for metastatic breast cancer with at least a 2 year "tumor-free" interval and with symptomatic bony, local-regional, pleural, or discrete pulmonary or mediastinal metastases had objective remission rates of 65 per cent at 6 months, 48 per cent at 12 months, 28 per cent at 18 months, and 16 per cent at 24 months.

Adrenalectomy↗
PubMed1977

Value of the history in the office diagnosis of breast cancer.

A review of the histories of 1059 patients with breast problems seen consecutively in office consultation revealed an incidence of breast cancer of 13%. Patients over 50 years of age or whose mother or sister had had breast cancer had a substantially greater likelihood of having breast cancer. The finding of the problem on routine examination, a family history of breast cancer in a relative other than the mother or a sister, or prominent breast pain or nipple discharge made the diagnosis of cancer less likely. Menstrual status, a history of previous benign disease, nulliparity, current hormone therapy and duration of symptoms did not help identify the patient likely to have breast cancer. Much time could be saved for both doctor and patient in taking the history from patients with breast disorders. Only the patient's age and the history of the mother and sisters with regard to breast cancer will help identify the "high-risk" patient. Other historical findings are either valueless or should be used to reassure these usually anxious women.

Adolescent↗
PubMed1977

Effect of current palliative treatment on the survival of patients with breast cancer.

The length of survival of 302 patients with breast cancer first treated between 1946 and 1949, who had mostly only contemporary radiotherapy for metastases, has been reviewed and compared with that of 578 patients, first treated between 1966 and 1969, who had modern endocrine therapy, cancer chemotherapy and radiation therapy. Although patients in the latter group demonstrated a significantly increased length of survival after the first metastases appeared, these differences were not substantial. In spite of impressive regressions in some patients with metastatic breast cancer after modern palliative therapy, the median survival after the first appearance of metastases has been increased only by about 6 months.

Breast Neoplasms↗
PubMed1977

Role of aspiration breast biopsy.

Review of the results of 100 consecutive aspiration breast biopsies disclosed that this technique failed to identify 11 of the 33 breast cancers in the series; however, it identified 3 breast cancers that were not recognized by clinical examination. In one patient who had a fibroadenoma, suspicious cells were seen in the material sent for cytologic examination. It is concluded that a negative aspiration biopsy does not contraindicate tissue biopsy when the clinical findings suggest cancer. Aspiration biopsy can uncover clinically unsuspected cancers. When the lesion appears to be malignant on a clinical basis, aspiration biopsy can obviate formal biopsy. In this way time is saved for all those involved and the fashioning of the mastectomy flaps is facilitated.

Biopsy, Needle↗
PubMed1976

Breast cancer and preceding clinical benign breast disorders. A chance association.

A review of 1059 patients seen in office consultation from 1970 to 1975 for breast disorders revealed that patients with clinically benign disorders were six times as numerous as those with breast cancer. Only 11% of patients with breast cancer had had a previous benign breast-biopsy specimen and on average they were 20 years older than the peak age for benign clinical disease. Of the 163 patients with a previous benign breast-biopsy specimen only 14 (9%) had breast cancer compared with 13% in women without such a history. It is concluded that clinical benign breast disorders do not predispose patients to cancer, and such women should not be singled out for special study.

Adenofibroma↗