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PubMed2000

[The place of surgery in the treatment of advanced localized, recurrent and metastatic breast cancer].

In the multidisciplinary treatment of locally advanced and metastatic breast cancer, aggressive surgical options can be chosen in selected cases. They may allow: survival to be prolonged by the resection of metastases (liver, ovary, lung), symptomatic treatment (bone pain, local recurrence, infiltration of the chest wall), prevention of potentially disabling complications (pathologic fractures, medullary compression), exclusion of another tumoural or non tumoural diseases. The decision to perform surgery has to be discussed between the surgeon and the oncologist so as to optimise its timing. Surgical treatment can follow induction therapy or can precede chemo- or hormonotherapy.

Abdominal Neoplasms↗
PubMed2000

Stromal sarcoma of breast: a case report.

A 34 years unmarried female was admitted with an ulcerated foul smelling growth in her right breast. On examination the fungating mass measured 17.5 cm x 15 cm in central and lower part of right breast involving the nipple and areola. The ulcer was covered with slough and rest part of the breast appeared bosselated. Her Hb was 4 g/dl and incision biopsy from the margin of the tumour showed histology of sarcoma. The patient was infused 6 units of blood and right sided total mastectomy was done. Histopathological examination confirmed it was a case of stromal sarcoma of breast. Chemotherapy was started with vincristine, adriamycin and cylophosphamide. The patient was doing well in next follow-up.

Adult↗
PubMedDate not supplied

Sensitivity of serum tumor markers CEA and CA 15-3 in breast cancer recurrences and correlation with different prognostic factors.

The aim of this study was to evaluate the correlation between serum tumor markers CEA and CA 15-3 in breast cancer (BC) patients with disease relapse and different prognostic parameters at first operation. Sixty-two women (median age 55 years, range 35-83 years) who had undergone curative surgery for pT1-2 pN0-1 M0 breast cancer developed local recurrences, distant metastases or contralateral BC during a median relapse time of 53 months (range 25-149 months). Sensitivity of CEA, CA 15-3, and CEA + CA 15-3 together was 40.3%, 41.9% and 59.7%, respectively. No correlation (p = NS) was found between tumor markers sensitivity and type of recurrence, surgical procedure, histologic subtypes and hormone receptors rate. CEA significantly (p < 0.01) correlated with the size of the tumor and axillary node status and CA 15-3 with the age of the patients. In conclusion, CEA and CA 15-3 should be considered complementary in detecting BC recurrences but their sensitivity is low and independent of the majority of the prognostic parameters that may be considered before relapse.

Adult↗
PubMed2001

Pure squamous cell carcinoma of the breast in a patient with previous adenocarcinoma of the breast: a case report and review of the literature.

We report a case of squamous cell carcinoma of the breast in a patient with previous adenocarcinoma in the unilateral breast. Squamous cell carcinoma is often cystic in nature with a variable presentation on mammogram. Its diagnosis necessitates the preclusion of a primary site of squamous carcinoma elsewhere in the body. The treatment of this cancer is similar to other types of breast carcinoma. Its prognosis remains unclear.

Breast Neoplasms↗
PubMed2000

[Skin sparing incision mastectomy and immediate TRAM flap breast reconstruction].

OBJECTIVE: In order to achieve a high-quality reconstructed breast, we improved the operation method using the skin sparing incision mastectomy and immediate TRAM flap breast reconstruction. METHODS: Patients with duct carcinoma in situ were selected to undergo mastectomy with a skin sparing incision. The site of the previous biopsy incision was marked around the areola, and then the preferred skin sparing incision included the nipple-areola complex and a margin around the biopsy site for the non-ptotic breast. The excised skin was replaced as precisely as possible with the TRAM flap skin immediately. While the mastectomy was being performed the TRAM flap was incised and elevated. The pedicled or free TRAM flap has been used for 34 patients. Nipple-areola reconstruction was made at the second stage. RESULTS: The results of the skin sparing breast reconstruction are better than other breast reconstruction techniques in the breast's shape, colour, sensation, symmetry and incision scar. CONCLUSIONS: Skin sparing incision mastectomy with immediate TRAM flap breast reconstruction technique is an ideal breast reconstructive method for the patients with breast duct carcinoma in situ. The advantages of the method include 1. The TRAM flap is an autograft without rejection; 2. The reconstructed breast has good shape and better sensation than other autograft reconstructive techniques since most breast skin has been spared; 3. The symmetry of the reconstructed breast with the contralateral breast is improved.

Adult↗
PubMed2003

Does fibrin sealant reduce drain output and allow earlier removal of drainage catheters in women undergoing operation for breast cancer?

Serosanguinous drainage after mastectomy and axillary lymph node dissection has traditionally been treated with the temporary use of closed suction drainage catheters. Use of drainage catheters is associated with wound infection, discomfort, nerve injury, and impaired arm movement. Commercially produced fibrin sealant has been proposed to reduce postoperative serosanguinous collections. We hypothesized that the intraoperative application of low-dose (2-5 cm3) fibrin sealant would reduce serosanguinous drainage and allow earlier removal of closed suction drainage catheters after operation for breast cancer. Fifty-five women with known breast cancer underwent either total mastectomy, modified radical mastectomy, or isolated level I and II axillary lymph node dissection. Twenty-six patients were treated with fibrin sealant and 29 served as control subjects. The application of fibrin sealant resulted in a significant reduction in overall duration catheters were needed (7 vs 8.3 days; P = 0.05). More importantly fibrin sealant reduced the time until 24-hour drain output was less than 30 cm3 (4.9 vs 6.2 days). Additionally fibrin sealant application resulted in a 60 per cent reduction in overall drainage amount after total mastectomy and a 32 per cent reduction after modified radical mastectomy. The application of fibrin sealant after axillary lymph node dissection did not decrease overall drainage amount. In conclusion fibrin sealant reduces serosanguinous drainage after total mastectomy and modified radical mastectomy and may allow earlier removal of closed suction drainage catheters.

Adult↗
PubMedDate not supplied

[Breast carcinoma in the elderly].

Breast cancer represents 40% of all carcinomas and is responsible for the 20% of deads due to a cancer in female population. Patients in more of 50% age over 65 years. 150 patients with breast cancer older then 65 years underwent surgery. T1 and T2 < 2 cm patients were treated with quadrantectomy and radiotherapy. T2 > 2 cm and T3 patients underwent radical mastectomy. T4 patients were treated with neoadjuvant chemotherapy before surgery. Mean follow up was 48 (range 12-78) months. 43 patients (28.6%) had a progression of the neoplasia. Five years mortality rate was 18.6%. Surgery nowadays represents the treatment of choice for breast cancer even in elderly woman. Associated diseases in these patients shouldn't always considered an absolute contraindication for surgery.

Age Factors↗
PubMed2003

Cystosarcoma phyllodes metastatic to the mandible: report of a rare case and literature review.

Cystosarcoma phyllodes is a rare breast tumor with variable malignant potential. Metastasis has been reported in a small percentage of cases. We describe the case of a 52-year-old woman who developed a large facial tumor 1 year after she had undergone a mastectomy for a rapidly enlarging breast neoplasm. The facial lesion was found to be a malignant cystosarcoma phyllodes metastatic to the mandible, and the patient died shortly after diagnosis. To our knowledge, this patient represents only the third reported case of a phyllodes tumor metastatic to the mandible.

Breast Neoplasms↗
PubMed1992

[Radiation-surgical treatment of cancer of the female breast].

Findings were reviewed of 1566 female patients with primary breast carcinoma treated with radical or total mastectomy followed by postoperative radiation therapy during the 22 year period 1960-82. The five-year overall survival for the axillary node-positive breast cancer group was 58.3 percent, as compared with 79.9 percent for the node-negative group. The survival rates were also analyzed in terms of age of the patients and number of the axillary positive nodes present. The ratios of observed deaths to expected deaths were turned from many times greater than unity into nearly the expected number, after ten year follow-up period. These findings showed that host factors are capable of destroying tumor cells both in node-negative and in node-positive patients. The significance of axillary negative nodes was emphasized. The rates of locoregional recurrences and distant metastases for node-negative patients were analyzed; these observations suggested that routine postoperative radiotherapy should be considered also in node-negative breast cancer patients.

Adolescent↗