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Biomedical subjects

M W van Beek

Publications and source records attributed to M W van Beek.

7 recordsLinked to original sources

Management of early breast cancer in southeast Netherlands since 1984. A population-based study. Regional Breast Cancer Study Group.

We studied changes in staging and treatment of patients with early breast cancer (TNM stage I and II) in eight community hospitals in southeast Netherlands between 1984 and 1991 and related these changes to the guidelines for the management of breast cancer drawn up by the regional Breast Cancer Study Group. Since 1984, the proportion of patients that underwent breast-conserving therapy (local tumour excision, axillary dissection, and irradiation of the breast) increased from 26% to 53%. Although the mean number of axillary lymph nodes examined by the pathologists increased significantly, the proportion of patients with positive lymph nodes remained unchanged. The proportion of patients with involved axillary nodes receiving any form of adjuvant systemic therapy increased from 49% to 82%. Therapeutic policy initially varied significantly from one hospital to another but gradually became more uniform. We conclude that, except for elderly patients, treatment of early breast cancer corresponded increasingly to the guidelines of the regional Breast Cancer Study Group.

Adult

[Increased incidence of breast cancer in southeast Netherlands between 1960 and 1989].

Trends in incidence, stage distribution and mortality of breast cancer were determined in the Southeastern Netherlands in 1960-1989. First and second primary breast cancers were analyzed separately. The incidence and mortality rates were age-standardised according to the European Standard Population. The incidence rate of first primary invasive breast cancer increased from 50 per 100,000 women per year in 1960-61 to 96 in 1988-89, and of second primary invasive breast cancer from 3.2 in 1965-66 to 7.8 in 1988-89. The incidence rate of first primary ductal carcinoma in situ (DCIS) increased from 0.3 per 100,000 women per year in 1975-76 to 2.8 in 1988-89 and of second primary DCIS from 0.06 in 1975-79 to 0.4 per 100,000 in 1985-89. The increase in first invasive primaries was observed in all age groups, but mostly at age 75 and over. The percentage with stage I tumours of the patients with a first primary invasive breast cancer increased from 7% in the sixties to 27% in the eighties, whereas the percentage of stage III and IV tumours combined, decreased from 39% in the sixties to 26% in the eighties. While age-adjusted incidence of first primaries almost doubled in the past thirty years, breast cancer mortality rose only slightly. However, breast cancer mortality showed a proportionate increase of total mortality from 4.5% in 1970-71 to 6.3% in 1988-89.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

The Multicenter Morphometric Mammary Carcinoma Project (MMMCP). A nationwide prospective study on reproducibility and prognostic power of routine quantitative assessments in The Netherlands.

The Multicenter Morphometric Mammary Carcinoma Project (MMMCP) has been set up to investigate prospectively the prognostic value and reproducibility of routine assessments of the morphometric Multivariate Prognostic Index (MPI) and other quantitative parameters in comparison with classical prognosticators and steroid receptors in breast cancer patients. In this project, 34 hospitals participate, divided over six geographically different regions. Of each patient entering in the study, multiple clinical and classical pathological parameters (including tumor size and lymph node status) as well as several quantitative parameters such as mean nuclear area, DNA index and mitotic activity index will be evaluated. Of all patients, the MPI will be assessed with tumour size, lymph node status and mitotic activity index. The quantitative assessments are performed in all consecutive breast cancers which enter the participating pathology laboratories, and all measurements are controlled in Amsterdam. The patient intake time will be from January 1, 1988 until January 1, 1990. It is expected that 3000 patients will enter in this study. Follow up data will be gathered up to 10 years. However, two to five years after the initiation of the Project, a first evaluation of the reproducibility and prognostic significance of routine MPI and other assessments in breast cancer patients will be possible. A detailed description of this project is given.

Breast Neoplasms

[Lymph nodes 1987].

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AIDS-Related Complex

Polyneuropathy due to polyangiitis overlap syndrome.

A patient presented with a mild polyneuropathy, developed a large intra-abdominal haemorrhage and died of cardiac arrest within a few days. Microscopic examination revealed a polyangiitis overlap syndrome (Fauci) with lesions in many organs, including the peripheral nerves and the heart. A myocarditis was considered to be the cause of death.

Humans

Mesenteric cysts.

7 new cases of cysts in the mesentery of the small bowel are presented, together with 54 clinically and histologically well documented cases from the literature. Most cysts are found in laparotomy for an acute abdomen. Almost half of the patients are under the age of 11 years. The cysts can be unilocular, multilocular or multiple. Cysts in the mesentery of the jejunum always had a chylous content. Most often the wall consists of an endothelial lining, smooth muscle, lymphatic tissue and lymphatic vessels. Inflammation and/or bleeding destroyed the endothelial lining and added granulation tissue to the histologic picture. With the exception of 7 cases, the cysts are probably of congenital and lymphatic origin. Trauma, infection, bleeding or volvulus can make a silent cyst manifest.

Abdomen, Acute