[Comprehensive treatment of breast cancer].
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Biomedical subjects
Publications and source records attributed to V S Datsenko.
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The results of treatment in 1362 breast cancer patients were analysed, depending on the extent of surgical intervention. An extended operation failed to improve the survival of the patients and, therefore, such operations seem to be indicated only in median-central localization of the tumor and the absence of axillary lymph nodes involvement. In surface location of the neoplasm and not enlarged axillary lymph nodes the Patey surgery proved to be warranted. For most patients with breast cancer radical mastectomy is remained to be the operation of choice.
The survival rate in breast cancer patients depending on the radiotherapy method employed was analysed. Based on the longterm follow-up of 1385 patients, it is shown that of all the methods of radiotherapy the preoperative irradiation, including the primary tumor site and all zones of regional metastatic spread, seems to be most preferable. Postoperative radiotherapy is a less advantageous technic, and it may be in use in case of lymphnodes metastases and an evident violation of anablastic principles during the operation. An accessory use of chemotherapy would improve the prognosis for breast cancer patients.
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Based on the findings of direct upper lymphography performed before and during the operation, the degree of radicality of the Patey surgery and radical mastectomy after the Holstead technic was studied in breast cancer patients. It has been shown that in technical respect the Patey operation is inferior in radicality to radical mastectomy and should be performed only on strict indications. It is believed that, it is not yet the time to use the Patey surgery in wide practice instead of radical mastectomy, since even the latter sometimes fails to provide the removal of all regional lymph nodes.
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The results of treatment in 324 patients with breast cancer are analysed. 159 females prior to surgery were subjected to irradiation of the mammary gland and axillary lymph nodes. Supra-subclavicular and parasternal zones were treated after radical mastectomy. The mammary gland and all regional zones of lymph outflow were irradiated prior to surgery in 165 patients. In stage 1, 3 and 5-year results of treatment were found to be identical in both series (88%). In stage II 62% of females in the first group and 77% in the second group survived for 3 years and 60% and 75% -- for 5 years, accordingly. In stage III a 3-year survival made 51% and 65% and a 5-year survival -- 25% and 49%, correspondingly. The rationality of preoperative irradiation of the mammary gland and all zones of lymph outflow is emphasized.
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