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At least 829 records · Page 46Linked to original sources
PubMed1988

Breast cancer: risk of axillary recurrence in node-negative patients following partial dissection of the axilla.

The estimated probability of false negative nodal staging was analysed in breast cancer patients who had lower axillary dissection in conjunction with mastectomy and who were initially characterized as node negative. The series comprised 3128 consecutive female patients with invasive mammary carcinoma treated by surgery alone according to a nationwide DBCG protocol, 77-1a (Danish Breast Cancer Co-operative Group). The median number of removed lymph nodes was four, range 0-30. Median followup period was 6.5 years, quartiles 5.5 and 8.0 years. Ipsilateral axillary recurrences appeared in 178 patients (5.7%) during the followup period. The estimated 5-year probability for developing axillary relapse, calculated on the basis of lifetable analyses, was 19% in patients with no lymph nodes removed, 10% with 1-2 removed and negative nodes, 5% with 3-4, 3% with 5-10, and 3% with more than 10 removed and negative lymph nodes. No detectable increase in estimated probability could be traced in patients with five or more nodes removed during followup beyond 5 years, while in patients with less than five nodes removed the probability of axillary recurrence ascended continuously. The study also revealed a significantly decreased survival in groups of patients with less than five nodes removed and negative compared with groups of patients with five or more nodes removed. It is concluded that lower axillary dissection is associated with a certain risk of overlooking lymph nodes metastases, whereby the patients may be deprived of optimal adjuvant therapy. Misjudgment of the qualitative axillary nodal staging is modest, provided that at least five lower lymph nodes are removed.

Actuarial Analysis↗
PubMed1995

Leiomyosarcoma of the breast. A case report.

A case of primary leiomyosarcoma of the breast in a 35-year-old woman is presented. The condition is rare, only 11 cases of primary leiomyosarcoma of the breast having been reported previously. The clinical and pathological features are reviewed.

Adult↗
PubMed1995

[Recurrences after conservative radiosurgical treatment of breast cancer].

From 1960 to 1989, 154 cases of recurrent breast cancer after conservative radiosurgery were treated at the Curie Institute. Relapse was discovered at clinical examination in 88% of the cases and mammography was only useful in 45%. In 18 cases (12%) an unpalpable tumour was discovered at mammography, especially for intragalactophoric tumors. Cytopuncture yielded a precise diagnosis in 83% of the cases. Overall survival rate after recurrence was 72% at 5 years (62% without metastasis). Survival rate was better for late recurrence, and poorer in cases with subclinical axillary invasion. Neither age nor type of treatment had any effect on survival. Indications for general associated treatment are based on: the invasive character of the recurrent tumour, axillary invasion, tumour size and delay to recurrence after initial surgery.

Breast Neoplasms↗
PubMedDate not supplied

A comparison of the effects of lumpectomy versus mastectomy on sexual behaviors.

The purpose of this study was to investigate the effects of lumpectomy and mastectomy on female sexual behaviors. It is assumed frequently that lumpectomy causes fewer sexual sequelae for the patient. Although review of the literature indicated consensus regarding the advantage of lumpectomy in preserving body image, no such consensus exists regarding preservation of female sexuality. The literature also was unclear regarding treatment and demographic factors that may be useful in identifying patients at risk for sexual difficulties. A convenience sample of 165 women participated in the study. Data were collected using the Sexual Behaviors Questionnaire and the Watts' Sexual Functioning Questionnaire. Findings indicate that no significant difference existed in sexuality between women treated by lumpectomy and those treated by mastectomy. Other factors with a significant positive effect on sexuality included a history of minimal alcohol use, absence of chemotherapy treatment, and tamoxifen use. Counseling women and their partners about the sexual side effects of cancer treatments is an important part of the health professional's role.

Adult↗
PubMed1995

Paget's disease of the nipple and angiosarcoma of the breast following excision and radiation therapy for carcinoma of the breast.

We report a case of bilateral angiosarcomas developing in breasts after radiation therapy. The angiosarcomas developed 7 years after the first dose and 3 years after the last dose of radiation. In addition, Paget's disease of the nipple was diagnosed in the right breast. c-neu overexpression was noted in the adenocarcinoma but not in the angiosarcoma. Neither tumor was immunoreactive for c-k-ras. The oncogenic expression of the radiation-induced angiosarcoma was different from that of the radiation-resistant adenocarcinoma. The simultaneous occurrence of angiosarcoma and Paget's disease of the nipple has not been reported previously. The importance of recognizing Paget's disease in post-irradiated breasts and complications of breast conservation therapy are stressed.

Adenocarcinoma↗
PubMed1994

[Phantom breast syndrome].

Phantom breast syndrome following mastectomy has been reported by other authors. However, the temporal course, character and extent of this phenomena have not been elucidated. In a prospective study we have investigated the incidence, clinical picture and temporal course of phantom breast syndrome. One hundred and twenty women who started postoperative control or treatment at the Oncology Department over a one-year period were interviewed by a standard questionnaire three weeks after the operation. One year later 110 patients and six years later 68 patients were interviewed again. The incidence of phantom pain and non-painful phantom sensations was respectively 13.3% and 15.0%, respectively three weeks after the mastectomy. 12.7% and 11.8% after one year, and 17.4% and 11.8% after six years. A significant relationship between preoperative pain and phantom breast syndrome was found, but neither age, cancer treatment or postoperative sequelae seemed to affect the occurrence of phantom breast syndrome. Scar pain was found to persist in 30.9% of the patients six years after the operation. The present incidence of phantom-related phenomena is close to the incidence reported by others. However, persistent phantom pain after mastectomy may be more common than usually expected. Also, the persistence of scar pain seems to be more common than generally expected.

Adult↗
PubMedDate not supplied

[Bilateral carcinoma of the breast: treatment and prevention, Review of the literature].

Authors analyze 256 patients admitted in III Clinica Chirurgica of University of Rome "La Sapienza" for breast cancer, from 1982 to 1992; 16 of them had later developed another neoplasm in the opposite breast. After a retrospective study of the clinical history of all patients they came to the conclusion that bilateral neoplasm frequency is similar to that reported in world literature (1-18%) (23, 9, 2). Moreover, are analyzed the primary risk factors for a bilateral carcinoma, and they consider the utility of the prophylactic surgical treatment of the opposite breast.

Adult↗
PubMed1994

Breast conserving surgery for early cancer: who, when, where, and how?

Breast-conserving surgery combined with postoperative radiation therapy is a therapeutic option for the early stages of breast cancer that has been proven efficacious by multiple studies with long-term follow-up. The validity of this approach has been recently questioned following the discovery of erroneous data submitted by a single investigator to a study of the National Surgical Adjuvant Breast and Bowel Project. When this individual's contributed data was eliminated, and the residual data reexamined and reviewed by National Cancer Institute statisticians, the conclusions of the study were unchanged and supported other clinical investigations in affirming that breast-conserving therapy is an effective and appropriate treatment for early breast cancer. Marked geographical, institutional, and individual physician variation persists today regarding the acceptance of breast-conserving surgery in the treatment of breast carcinoma. Currently, the trend, however, is toward increased acceptance and utilization of this treatment option. A woman's choice of treatment can be remarkably enhanced if she is carefully provided the pros and cons of all treatment options and then allowed to choose.

Breast Neoplasms↗
PubMed1994

Malignant cystosarcoma phyllodes.

UNLABELLED: This study reviewed 26 women who had resection of a malignant cystosarcoma phyllodes. Clinical presentations were palpable mass, 25; pain, 11; and ulceration, 2. Definitive surgical therapy was radical mastectomy (RM), 2; modified radical mastectomy (MRM), 14; total mastectomy (TM), 4; and partial mastectomy (PM), 6. Tumors ranged in size from 1-20 cm (median, 7 cm). Eight patients developed recurrent disease after 10-45 months. Local recurrence was more likely after TM and PM than after MRM and RM (P < 0.05). Patients who developed local recurrence only were treated by wide re-excision, and all such patients are alive with no evidence of disease at 5-25 years. Only one of 16 patients undergoing axillary dissection had involved lymph nodes. Four patients whose tumors ranged from 5-8 cm and who underwent one RM and three MRM developed systemic recurrence; all died of their disease after 15-48 months. CONCLUSION: 1) Although there is a higher local recurrence after PM and TM as compared with MRM and RM for malignant cystosarcoma phyllodes, the local recurrence can be treated with wide excision without affecting long-term survival; 2) systemic recurrence was not related to size or extent of resection; 3) axillary dissection does not predict for or prevent recurrence.

Adult↗
PubMed1994

[Intraductal spread of carcinoma: a risk for breast conserving surgery].

Intraductal spread of carcinoma (ISC) was defined as "DCIS clearly present extending beyond terminal duct-lobular unit, or present prominently within large ducts," using a sequential slicing of tissues and 3-D reconstruction of tumors. We then analyzed the relationship between ISC in specimens obtained by breast conserving surgery (BCS) and carcinoma residue in specimens obtained by total mastectomy. We found a strong correlation between the ISC factor in BCS tissues and the carcinoma residue in mastectomy specimens. Among 12 patients under observation without mastectomy, 3 patients subsequently developed breast carcinoma. Two of the 3 patients demonstrated ISC in BCS specimens. One of 10 patients without ISC, however, developed carcinoma, suggesting that the ISC is a risk factor in breast conserving surgery for breast cancer patients.

Adult↗
PubMed1994

[Reconstructive surgery in breast cancer operation].

We reported our experience with immediate breast reconstruction after partial or total mastectomy. In patients who underwent breast conserving surgery (BCT), an immediate transposition of adipose tissue with latissimus dorsi muscle vascular pedicle was carried out with the aim of improving cosmetics after wide excision. In those who received modified radical mastectomy, immediate breast reconstruction (MIBR) using a transverse abdominomyocutaneous flap or latissimus dorsi myocutaneous flap was carried out. Although either BCT or MIBR was performed at the patient's request, reconstructive surgery thus plays an important role in breast cancer operation.

Adult↗
PubMed1993

Effects of early discharge from hospital after surgery for primary breast cancer.

OBJECTIVE: To evaluate the effects of early discharge from hospital on women being operated on for primary breast cancer. DESIGN: Open study in self-selected patients. SETTING: Karolinska and Sabbatsberg Hospitals, Stockholm. SUBJECTS: 169 consecutive patients operated on for primary breast cancer. MAIN OUTCOME MEASURES: All patients were asked to fill in a questionnaire about their perception of their disease and factors associated with the operation. RESULTS: 118/169 patients participated, and of these 28 (24%) chose early discharge with the drain still in place. They were compared with the 90 patients (76%) who were discharged without a drain. The median stay in hospital for those who chose early discharge was 2 days, and for those who remained in hospital until the drain was removed, 6 days. There were no differences between the groups in type or incidence of complications, and the groups were equally satisfied with their length of hospital stay and their treatment in hospital. Those who opted for early discharge were significantly younger than those who did not (mean SD) 52 (14) compared with 62 (13) years, p = 0.001). CONCLUSION: Early discharge from hospital with the drain still in place after operation for primary breast cancer was not found to be associated with any untoward events.

Age Factors↗