From 1973 to 1980, a controlled clinical trial was carried out at the National Cancer Institute of Milan to compare the Halsted mastectomy with breast quadrantectomy and axillary dissection followed by radiotherapy in patients with breast cancer of less than 2 cm in size. Cases of breast cancer classified as T1N0 were randomized into the two treatment procedures: 349 cases were treated with the Halsted mastectomy and 352 with the quadrantectomy technique. The two series were comparable with regard to age distribution, size, site of primary tumor, menopausal status and frequency of axillary metastases. Three local recurrences occurred in the Halsted group and one in the quadrantectomy group. Actuarial curves showed no difference in the two series with regard to disease-free and overall survival. In view of these results, mastectomy appears to be an unnecessary mutilation for patients with breast carcinomas less than 2 cm in size and no palpable axillary nodes.

Breast Neoplasms↗

PubMedDate not supplied

Chemoprevention of breast cancer.

Chemoprevention of cancer is a new branch of the medical science and represents a topic of increasing concern in public health. Over the last decade chemoprevention has been extensively studied from many points of view, and topics in the field of chemoprevention have expanded considerably. Breast cancer, the most common malignant neoplasm in women, is one of the areas of clinical interest for chemoprevention. In this paper the authors synthesized the "status of art" in chemoprevention of breast cancer with retinoids and antiestrogens.

Breast Neoplasms↗

PubMedDate not supplied

[Adjuvant chemotherapy following liver metastasis resection in neoplasms of the colorectum].

INTRODUCTION: Adjuvant chemotherapy after hepatic resection of colorectal metastases has been advocated because of the significant risk of tumor recurrence. Data presented in literature show unequivocally that the probability of recurrence and tumor-related death exceeds survival. Although the initial site of disease recurrence varies, both intrahepatic and extrahepatic organs are at risk for tumor progression. PATIENTS AND METHODS: To reduce the risk of tumor progression after hepatic resection of colorectal metastases, multiple chemotherapy approaches have been designed. Treatment approaches have varied by chemotherapeutic agents, route and schedule of administration, and duration. RESULTS: A significant difference in survival between patients treated by resection alone and resection with adjuvant chemotherapy is not evident from these data. DISCUSSION: Metastatic inefficiency is a major driving force in the development of metastatic patterns. Then, the probability of synchronous seeding (from primary colorectal carcinomas) of hematogenous metastases in the liver, lungs, and other organs is less than metachronous seeding, in which only liver metastases are predominantly seeded from the hepatic metastases, and arterial metastases are predominantly seeded from the pulmonary lesions. This sequential development of metastatic patterns creates windows of potential therapeutic opportunity during which metastatic disease is confined to the liver alone. CONCLUSION: The risk of recurrence after hepatic resection of colorectal metastases clearly warrants further prospective study of adjuvant therapy to improve survival. Future trials of adjuvant therapy after hepatic resection of colorectal metastases must address the patterns of tumor recurrence and account for adjuvant chemotherapy given previously, after resection on the primary colorectal carcinoma.

Chemotherapy, Adjuvant↗