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At least 811 records · Page 45Linked to original sources
PubMed1990

A prospective, randomized double-blind study of the use of antibiotics at the time of mastectomy.

The ability of perioperative cefazolin to reduce the incidence of postoperative wound infection in patients undergoing ablative surgical treatment for carcinoma of the breast was tested in this prospective, randomized, double-blinded study. From May 1983 until December 1985, 118 women were divided into two groups at random. Group 1 consisted of 59 patients and received cefazolin and group 2 was made up of 59 patients who received a placebo. The groups were similar with respect to age, operative procedure, operative time and time to discharge after operation. Three infections occurred among those in group 1 and five among those in group 2 (p = 0.72). The time to onset of infection was delayed in the patients in group 1 versus those in group 2 (17.7 days versus 9.6 days, p = 0.04). Six of eight infections occurred in patients in whom an interval between biopsy and definitive surgical treatment was present. Prophylactic antibiotics in mammary operations did not reduce postoperative wound infections in this study.

Breast Neoplasms↗
PubMed1989

[Reduction of functional inoperability in patients with breast cancer].

The somatic condition of patients with breast cancer was assessed. Preoperative correction and intraoperative control owing to which 90 percent of the patients could radically be operated on were considered. Only 5 percent of the elderly patients were operated on palliatively in view of the correction failure. Thus as a result of the goal-oriented preoperative preparation none of the patients with breast cancer was dented surgery according to functional contraindications. The elderly age was not related to the surgery denial or its scope restriction.

Adult↗
PubMed1989

Local postoperative morbidity following pre-operative irradiation in locally advanced breast cancer.

The authors have reviewed the medical files of 100 patients with locally advanced breast cancer (Stage III), who were treated in the Department of Surgery at the Institut Jules Bordet between 1974 and 1988. All patients received pre-operative radiotherapy (average total dose 45 Gy), which was associated with chemotherapy in 74% of patients. All patients were subsequently subjected to surgery, using a modified mastectomy in 92% of cases. Our data reveal an incidence of 25% local wound infection, 34% delayed wound healing, 63% seroma formation and 22% lymphoedema of the upper limb. It seems that local postoperative morbidity is increased in patients pre-operatively irradiated. This indicates that pre-operative chemotherapy may be preferable in these patients to minimize the local postoperative morbidity and its impact on the quality of life.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Evaluation of various surgical methods in the treatment of breast cancer].

The author analyses 5-year results of the treatment of 548 patients with breast cancer according to the type of the operative intervention: Halsted's radical mastectomy, Peity's modified radical mastectomy, and mastectomy with axillary lymphadenectomy. In stages T1-2, N0, M0 the results of all three types of operations were the same. No statistically significant difference was revealed between Halsted's mastectomy and modified radical mastectomy in stages T2-3, N1-3, M0 which allows it to be recommended for wider use.

Adult↗
PubMed1989

[Breast carcinoma: breast-preserving therapy and cosmetic results].

Conservative surgery and radiation therapy for breast cancer is now a well accepted alternative to modified radical mastectomy but the esthetic results are not always satisfactory and often inferior to mastectomy and reconstruction of the breast. The different problems are discussed. A list of selective criteria for limited surgery is established. The author warns against the routine use of conservative surgery and radiation. He gives an overview of the different breast reconstruction techniques.

Adult↗
PubMed1988

[Breast carcinoma in men: radiotherapy and treatment results].

The treatment of 34 men with stage T1 N0 M0 to T3/4 N1 M0 mammary carcinomas was followed by a five-year survival rate of 70%. Three patients suffering from initial remote metastases died after 2 to 3.5 years. The probability of a five-year survival decreases with increasing tumor growth and axillary involvement. The prognostic effect of receptor state and grading could not be investigated in our patients. Our own data as well as recent data from literature suggest that, with respect to TNM stages in mammary carcinoma, there is no prognostic difference between men and women. It is not very clear at present if postoperative irradiation exerts a favorable influence on the survival rate. However, it reduces the local recurrence risk for men and women. 45 Gy in five weeks should be considered as a minimum dose. The indications for postoperative irradiation are discussed.

Adenocarcinoma↗
PubMed1988

A randomised controlled trial of adjuvant hormono-chemotherapy in Stage II breast cancer.

From 1979 to 1984 women with histologically proven Stage II breast cancer were entered into a randomised controlled trial of adjuvant hormono-chemotherapy following mastectomy. Adjuvant therapy was started within 2 weeks of surgery and was given for 6 months as continuous 'Tamoxifen' and 6-monthly cycles of vincristine, adriamycin and cyclophosphamide (VAC). Of the 157 women randomised 82 were assigned to the control group and 75 to the adjuvant group. Comparing the two groups by life table analysis the rate of recurrence was found to be significantly greater in the control group (n = 46) than in the adjuvant group (n = 25) (Peto log rank test chi 2 = 7.46 P less than 0.01). Although there were more deaths amongst the control patients (n = 31) than in those randomised to receive adjuvant therapy (n = 18), this difference did not achieve statistical significance (chi 2 = 2.80 P less than 0.1). This analysis has shown that although adjuvant hormono-chemotherapy may significantly delay recurrence the trial has failed to demonstrate any significant improvement in the survival of women with Stage II breast cancer following mastectomy.

Adult↗
PubMed1988

Stage II breast cancer is not simply a late stage I.

Conventional wisdom holds that stage II breast cancer (with positive axillary nodes) is a late stage I (with negative axillary nodes). The use of direct (e.g., 5-year) survival analysis, has led to the concept that these stages reflect a "delay" in diagnosis. Controlled clinical trials and demographic cancer registries, in which life table analysis of survival is used, provide data that require that this concept be reconsidered and perhaps discarded. Survival data published by NSABP B04 and the Connecticut Tumor Registry show that deaths in both stages start shortly after diagnosis but show different annual rates of dying. The anticipated "delay" (lead time bias) is not seen. These rates are permanently and consistently different. The local recurrence rates occurring in the two stages are different. The clinical response to tamoxifen citrate in postmenopausal women and chemotherapy in premenopausal women has been shown to be different between the two stages. Histopathologic examination of the primary tumor shows the two stages to be different with respect to size of tumor at time of diagnosis and the presence of lymphatic and vascular invasion. The conclusion must be reached that the two stages represent variants of breast cancer disease; stage II is not simply a late diagnosis of stage I.

Antineoplastic Agents↗