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At least 433 records · Page 24Linked to original sources
PubMed2002

Retrospective study of conservation surgery for breast cancer with or without axillary dissection.

BACKGROUND: It is already known that for breast cancer patients, an axillary dissection or locoregional radiation has no major effect on survival with a simple mastectomy. We analyzed whether axillary dissection improved the prognosis for breast conservation surgery. METHODS: From 1982 to 1995, 31 patients underwent axillary dissection and 33 did not in association with breast conservation surgery performed at our institution. Median follow up was at 55 months, ranging from 3 to 210. Survival rates of patients were analyzed retrospectively. RESULTS: In the dissection group, 8 patients had recurrence and 5 died within 3 years, yielding a relapse-free survival rate of 71%. In the non-dissection group, 7 patients had recurrence, 3 died within 3 years, with a relapse-free survival rate of 79%. Figures for overall survival, relapse-free except breast and relapse-free for breast at 5 years were 93%, 73%, and 96% for the dissection group, and 93%, 89%, and 89% for the non-dissection group, respectively. No difference was found in survival rates between the two groups. Adjusted by Cox's regression analysis, survival rates of overall, relapse-free, relapse-free except breast and relapse-free for breast, at 5 years were 86%, 71%, 77%, and 90% for the dissection group, and 100%, 78%, 85%, and 95% for the non-dissection group, respectively. No survival benefit was found in axillary dissection. The first site of recurrence was in the affected breast in 3 patients and in other sites in 5 patients for the dissection group, while for the non-dissection group it was in the affected axilla in 1 patient, the skin of the affected breast in 1 patient, the affected breast in 3 patients, and other sites in 2 patients. In the non-dissection group, a patient who had recurrence on the skin of the affected breast, subsequently had an axillary recurrence on the same side with plexus paresis. CONCLUSION: In breast conservation, prophylactic axillary dissection seems to be omitted, but the axilla of the affected side should be examined for metastasis while treatment is possible.

Adult↗
PubMed2003

Unusual case of bowel infarction with invasive Aspergillus in an immunocompromised patient.

INTRODUCTION: We report a patient with bowel infarction due to invasive Aspergillus infection as a result of prolonged chemotherapy-induced neutropenia. CLINICAL PICTURE: The patient was given neoadjuvant chemotherapy with doxorubicin, docetaxel, and capecitabine for a breast tumour. She developed prolonged neutropenia, Escherichia coli and Candida krusei sepsis, acute arterial thrombosis of the left lower limb, and invasive aspergillus infection. TREATMENT: She underwent a subtotal colectomy, small intestine resection and an above-knee amputation. OUTCOME: The hospitalisation was complicated with methicillin-resistant Staphylococcus aureus pneumonia and short gut syndrome. She subsequently underwent simple mastectomy with axillary clearance and received adjuvant chemotherapy and radiation without complication. CONCLUSION: Chemotherapy should be protocol-directed. In a non-trial situation, protocol must have a sound basis, proven safety, and efficacy. Aspergillus infection is uncommon in patients with solid tumours; prompt treatment must be started on high suspicion.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

[Treatment analysis of 26 patients with breast ductal carcinoma in situ].

OBJECTIVE: To study the appropriate surgical treatment for breast ductal carcinoma in situ (DCIS). METHODS: Twenty-six such patients treated between 1992 and 2001 were retrospectively analyzed. Among them, 3 patients were treated by simple mastectomy, 23 patients by mastectomy and axillary lymph node dissection, 8 patients by chemotherapy and one patient by radiotherapy after operation. Median follow-up was 42 m (rang 12 - 112 m). RESULTS: Except 3 of these 26 patients lost in follow-up and 1 patient died from diabetes mellitus, all the other 22 patients survived over 5 years. All lymph nodes dissected from 23 patients were negative. After surgery, 3 patients developed lymph edema of the arm. CONCLUSION: DCIS, lacking the potential of metastasis, is not invasive. Conservative breast surgery without lymph node dissection is feasible for most DCIS patients.

Adult↗
PubMedDate not supplied

[Adenoid cystic carcinoma of the breast. Case report].

We report a case of adenoid cystic carcinoma of the breast in a 62-year-old lady. This tumor is a rare histologic form of breast cancer, associated with a favorable prognosis, and a special clinical behavior. It is mainly diagnosed on morphological grounds, by identifying two populations of neoplastic basaloid myoepithelial and epithelial cells with extracellular deposits of eosinophilic basement membrane-like substance. Lymph node metastases are rare. Partial or simple mastectomy is an adequate treatment. Axillary lymph node dissection may not be necessary.

Breast↗
PubMed2003

Cystosarcoma phyllodes of the breast: a clinicopathological study of 11 cases.

Eleven cases of phyllodes tumour were managed at a single institute over 12 years period. All patients were females, the mean age was 48 years, painless breast lump was the commonest presentation, the left breast was affected in (55%), the upper outer quadrant was the most commonly involved site (60%). Four cases were malignant and the remaining 7 were benign. The diagnostic accuracy rate of fine needle aspiration cytology and intraoperative frozen section was 17% and 37.5% respectively. Adequate treatment was wide local excision in benign cases and simple mastectomy in malignant tumour. At a mean follow-up of 37 months the local recurrence and distant metastasis rate was 27% and 9% respectively.

Biopsy, Needle↗
PubMed1992

[Malignant cystosarcoma phyllodes].

The authors deal with the clinical and pathological aspects and histopathological criteria of malignity of cystosarcoma which are important from the aspect of assessment of the extent and type of surgical intervention. Large malignant cystosarcomas and cystosarcomas taking up the whole breast with damage of the skin are indicated for simple mastectomy, while small malignant cystosarcomas (i. e. in relation to the size of the breast) can be treated by a wide local excision with a safety margin, as some primary as well as recurrent phylloid tumours behave in a benign way or may transform into a fibroadenoma or a dysplastic focus. Moreover contrary to carcinoma of the breast, there is no association with a multicentric character of the disease. Axillary lymph nodes are only rarely affected; therefore dissection of the nodes is not necessary.

Adult↗
PubMed1992

Cystosarcoma phyllodes of the breast: histologic features, flow cytometric analysis, and clinical correlations.

The histologic features of 187 cases of cystosarcoma phyllodes of the breast were reviewed. The tumors were divided into histologically benign, borderline, and malignant categories. Correlation with clinical outcome was available in 100 cases. Overall rate of local recurrence was 28% (benign, 27%; borderline, 32%; malignant, 26%). Metastases occurred in eight of 100 cases (two borderline and six malignant). Although no histologic features were predictive of local recurrence, stromal overgrowth, mitotic rate greater than 15 per 50 high-power fields, and cytologically atypical stromal cells characterized seven of the eight tumors that metastasized. These features were not evident in the eighth case. Flow cytometric analysis of eight tumors (four benign, two borderline, and two malignant) showed discordance between histology and DNA content in three cases. There was slightly better correlation of histology and S-phase fractions. Based on these results demonstrating the difficulty in predicting clinical outcome, wide local excision remains an appropriate initial method of treatment. Simple mastectomy may be necessary for very large tumors and should be considered in histologically malignant tumors and cases with multiple recurrences, since some recurrent tumors in this series showed increasingly unfavorable histologic features.

Adolescent↗
PubMed1963

THE DIAGNOSIS AND TREATMENT OF TUBERCULOSIS OF THE BREAST.

Tuberculosis of the breast is a rare disease. It may be primary-confined to the breast, or secondary to tuberculosis elsewhere. Five cases are reported of which three were primary.The clinician confuses the disease with pyogenic breast abscess and cancer. The pathologist may confuse the disease with comedomastitis. Definite diagnosis must rest on bacteriological proof, that is, positive tuberculous culture and guinea-pig inoculation.Treatment of the disease may be either medical or surgical. Medical treatment in our hands has been long and expensive, and the disease tends to reappear in further pregnancies. Surgical treatment, which usually consists of simple mastectomy, is preferable.

Abscess↗
PubMed1965

BREAST CANCER AT THE ONTARIO CANCER CLINICS, 1938-1956: A STATISTICAL REVIEW.

In Ontario, breast cancer accounts for one death in every 27 among females. In 1938-1956 some 40% of all new cases were registered at the Ontario Cancer Foundation's regional clinics. The five-year crude survival rate for 11,393 women was 45.4%, and for 91 men, 36.3%. Survival rates were strongly affected by extent of disease; when this was allowed for, pregnancy and treatment method were also found to influence survival rate. Simple mastectomy with radiotherapy gave results that appeared comparable to those after radical mastectomy, alone or with radiotherapy. There was a 20% improvement in the crude five-year survival rate over the period of the survey. The need for great caution in interpreting these findings is stressed.

Breast Neoplasms↗
PubMed1951

Giant intracanalicular fibroadenoma. With report of five cases.

Five cases of giant intracanalicular fibroadenoma ("cystosarcoma phylloides") were observed at one hospital in a period of three years. In a search of the literature, additional reports of breast tumors of this kind, not included in previous reviews, were noted. As there is record of 229 cases, it would appear that this rapidly growing benign tumor should be kept in mind in the diagnosis of masses in the breast. If removal is incomplete, there may be recurrence. Simple mastectomy is the treatment of choice. Radical mastectomy should be avoided.

Adult↗
PubMed2004

Clinically 'benign' breast lumps: sarcoma in hiding?--Case reports and literature review.

Breast sarcoma is a very rare entity that accounts for less than 1% of all breast malignancies and less than 5% of all soft tissue tumours. Although uncommon, we highlight 2 recent cases encountered at our centre. The aim is to emphasise their apparent benign appearance on physical examination, so that readers will be alerted in a similar clinical setting. Medline was used to search for relevant articles concerning the pathology, treatment modalities and long-term prognosis of patients with this rare illness. We also reviewed soft tissue sarcomas found elsewhere. Articles relating to phyllodes tumour were excluded or only relevant sections used. We discuss the controversy regarding axillary lymph node clearance and the use of radiotherapy. Despite conflicting reports and lack of clinical studies, we believe that a simple mastectomy will suffice as adequate treatment, hence avoiding the undesirable side effects of chemotherapy or radiotherapy.

Adult↗
PubMed2004

[The breast phyllodes tumor: surgical therapy following histological transformation. Case report].

The Authors report a clinical case of mammary phyllodes tumor recurrence; characterized by the histological transformation of the recurrence respect to primary tumor. PT are 0.3-1% of all mammary neoplasia. They are classified with Tavassoli's criteria (1999). The surgical treatment of PT is the wide excision (WE). Local recurrences are detected in about 20% of patients undergone to surgery. Surgical therapy of recurrences depends on the histological grade of primary lesion. Authors believe it is necessary to perform simple mastectomy when high grade PT recurrences are detected and when histological transformation of the lesion changes from low grade to high grade.

Breast Neoplasms↗
PubMed2004

[A case of local advanced breast cancer with multiple lung metastases successfully treated with multimodal therapy].

We report a case of local advanced breast cancer with multiple lung metastases (T4bN2M1) achieving a significant improvement of QOL by multimodal therapy with chemotherapy, antibody therapy, radiation therapy and surgery. The patient was a 47-year-old woman with mental deterioration who had an ulcerative breast cancer with multiple lung metastases. Breast biopsy led to a diagnosis of an invasive ductal carcinoma positive for erbB2 protein expression. She received 6 cycles of tri-weekly docetaxel (60 mg/m2) and weekly trastuzumab. Although metastases in the lung disappeared after chemotherapy, the response of breast ulceration was less satisfactory. Simple mastectomy followed by radiation therapy (50 Gy) to the axilla was performed as a palliative treatment. No signs of recurrence were observed for more than 14 months of treatment by trastuzumab. Multimodal therapy can improve patient QOL and the clinical outcomes in Stage IV local advanced breast cancer.

Antibodies, Monoclonal↗
PubMed2004

[Surgical therapy of the ductal carcinoma in situ].

AIM: Rates of the newly-detected DCIS reach up to 20% in developed countries. There is no unified therapeutic scheme to deal with the disorder. The aim of this work is to assess the author's own therapeutic results. METHODOLOGY: From 1999 until 2003, 11 female patients suffering from the DCIS were treated and 2 DCIS female patients were treated using microinvasion. The diagnosis was established 5x by the core-cut and 8x by the surgical excision. RESULTS: The size of the tumors varied from 0.5 cm to 6.0 cm. Conservative procedures were performed 11 times, a simple mastectomy once and a mastectomy with reconstruction once, as well. The sentinel lymphonodes were examined in all cases and once the examination was accompanied by the axilla dissection. The number of the sentinel lymphonodes was 29. All of the lymphonodes were negative. Seven female patients were given a complementary therapy. All female patients have had no local relapse in the breast and have had no signs of the disease process since. The average follow-up time is 13.5 months. CONCLUSION: The conservative procedures sufficiently provide treatment of early forms of the DCIS of the breast. The sentinel lymphonode biopsy is a patient- kind method, giving exact information on the status of the axillary lymphonodes and it is considered a suitable part of the DCIS therapy.

Breast Neoplasms↗
PubMed1992

[Breast cancer in a male. Report of a case].

The authors studied the clinical history of a male patient, 51 years old, from Puerto Armeulles, Chiriquí, with the diagnosis of breast carcinoma, III A, who was treated with simple mastectomy and systemic cytotoxic therapy, with 5 FU, Adriamycin and Cyclophosphamide at three weeks intervals, completing six cycles, followed by radiotherapy to the tumor site and the areas of lymphatic drainage, and hormonal therapy with Tamoxifen. The patient is now in good health and without clinical, radiographic or enzymatic evidence of tumoral activity, twelve months after the diagnosis.

Breast Neoplasms↗
PubMedDate not supplied

[Maffucci's syndrome. Case reports and literature review].

Maffucci syndrome is a rare, congenital disease, which is associated with the appearance of multiple enchondromas (possibility of malignant transformation in 20 to 100%), soft tissue hemangiomas and other mesenchymatous injuries. Case 1 is a 33-year-old female who presented with multiple nodules predominantly in upper extremities. Upon examination, there was deformity in articulation and nodules on the hands, which were soft and moveable. There were bony shavings in the second and fourth fingers of the left hand (enchondromas and atypical cells associated with hemangioma esclerosante). Maffucci syndrome was diagnosed. Later, excision of subcutaneous nodules in superior extremities was performed along with excision of nodules in both hands and hypochondrium (enchondroma injuries of left hand and hypochondrium, hemangioma in right hand). There was dysarticulation of the second finger at the metacarpal level of the phalanges of the left hand (chondrosarcoma). The patient is being followed up currently. Case 2 is a 26-year-old female. The patient had a history of subcutaneous abdominal tumor, exostosis, nodules and nodule in right breast. Upon examination, a tumor was found in the right breast, exostosis of right tibia, injury to the right wrist and left thyroid nodule. A simple mastectomy and axillary dissection was performed (fibroadenoma to intracanalicular and 14 negative lymph nodes). Later, left thyroidectomy and lumpectomy in right wrist were performed (hyperplasia to nodular thyroid and hemangioma cavernous). There was injury in the carpus of the right hand and elbow (hemangioma cavernous and synovial tissue with fibrosis and enchondroma). A diagnosis was made of Marffucci syndrome associated with mesenchymatous tumors. The patient was in poor general health and did not survive this hospitalization.

Adult↗
PubMed2005

[Phyllodes tumor and pregnancy. A report of a case].

Phyllodes tumor is a rare breast fibroepithelial neoplasm of the breast, predominant in females (0.3 to 0.5%). Few cases have been described in males. Phyllodes tumor during pregnancy grows fast and its size is relatively big. These tumors can be classified as benign, malignant or neighboring. A 32-year-old patient at 23.4 week of gestation was admitted in the National Institute of Perinatology with a rapidly growing mass in the right breast; diagnosis confirmed by ultrasound study reporting echoic images on right breast, 10 x 10 cm the greatest and 3x3 cm the smallest. A simple mastectomy was performed at the 26.6 week of gestation on the right breast. A possible phyllodes tumour in the right breast was observed during surgery, weight 9.6 pounds, with partial infiltration to major pectoral muscle. Pathology reported a benign phyllodes tumor in the right breast, with surgical borders free of tumor. Phyllodes tumor is rare and can occur during pregnancy. It is unknown if the tumor is hormone-dependent. The growth of a tumor on a subsequent pregnancy is not necessarily associated with recurrency or with a new disorder on the patient, who has had a complete excision.

Adult↗