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At least 109 records · Page 6Linked to original sources
PubMed1989

In situ carcinoma of the breast.

The optimal management of ductal carcinoma in situ of the breast is controversial. With the introduction of the National Mammographic Breast Screening Programme the condition will be encountered more frequently. We have reviewed 76 patients from a 12-year period treated by one surgeon (R.W.B.) at the Nottingham City Hospital. Fifty-nine patients had either ductal carcinoma in situ or lobular carcinoma in situ; 17 patients had Paget's disease. The mean age at diagnosis was 54 years and the commonest mode of presentation was with a palpable breast lump. Pre-operative mammography was performed in 31 patients with ductal carcinoma in situ and 28 were reported as showing malignancy. Patients with a lesion in the breast parenchyma were treated either by mastectomy (simple, subcutaneous or 'wedge'--see text) or by lumpectomy and radiotherapy. Patients with Paget's disease were treated by simple mastectomy, wedge mastectomy or a cone excision of the nipple and underlying tissue. The mean follow-up period was 65 months. Patients treated by any of the procedures less than simple mastectomy had a significant chance of developing local recurrence. A detailed histological review was made and grade, microinvasion, calcification, necrosis and completeness of excision were assessed for each tumour. None of these factors was correlated with subsequent local recurrence.

Adult↗
PubMed1993

Partial mastectomy without radiation is adequate treatment for patients with stages 0 and I carcinoma of the breast.

The treatment of potentially curable carcinoma of the breast has changed from one operation, radical mastectomy, to a flexible approach. At the Cleveland Clinic, we use four types of treatment for primary potentially curable carcinoma of the breast (Stages 0, I and II)--modified radical mastectomy, simple mastectomy, partial mastectomy with postoperative adjuvant radiation therapy and partial mastectomy without radiation therapy. The latter treatment (partial mastectomy without adjuvant radiation) is controversial. We recommend this procedure for patients with T(is) and T1 carcinomas that appear to be localized, without lymph node metastases, Stages 0 and I disease. The overall and disease-free survival rates are similar to those of patients having modified radical or partial mastectomy with radiation. Local recurrence is slightly higher at five years (11.0 percent) as compared with the other procedures, but at ten years, is only 16.1 percent, a figure comparable with patients having partial mastectomy with radiation (14.4 percent). For patients with Stages 0 and I carcinoma of the breast, the addition of postoperative radiation therapy after partial mastectomy seems to be unnecessary.

Breast Neoplasms↗
PubMed2005

Locoregional recurrence after management of carcinoma breast.

OBJECTIVE: To determine the rate of locoregional recurrence, disease-free interval, site and pattern of locoregional recurrence and the significance of different factors for predicting locoregional recurrence in patients with stage II and III carcinoma breast. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Surgical Unit-1, Jinnah Hospital, Lahore from September 2001 to December 2002. PATIENTS AND METHODS: Criteria for including patients in this study was female patients with stage II and III carcinoma breast who presented in our unit from 1995-2002 and underwent surgical (modified radical mastectomy, simple mastectomy with axillary sampling) and non-surgical (chemotherapy, radiotherapy, hormonal therapy) treatment of carcinoma breast. Record of 98 patients was evaluated for rate of locoregional recurrence, disease-free interval, site and pattern of locoregional recurrence and different clinical factors like stage of carcinoma, tumour size, lymph node status and histopathology were assessed for association with locoregional recurrence. RESULTS: After a mean follow-up of 3.5 years, 17 patients developed locoregional recurrence. Mean disease free interval in stage II was 30 months and only 9.5 months in stage III. Lymph node positivity was associated with locoregional recurrence (p-value<0.05). Chest wall was commonest site of recurrence (73%). Single spot recurrence was common in stage II whereas multiple spot recurrence and field change was more common in stage III. Addition of radiotherapy to surgery decreased the locoregional recurrence but chemotherapy had no significant effect on prevention of locoregional recurrence. CONCLUSION: In this series 17.34 % patients developed locoregional recurrence for mean follow-up duration of 3.5 years. Mean disease-free interval was 20.52 months. Lymph node involvement had significant correlation with LRR.

Breast Neoplasms↗
PubMed1984

Breast carcinoma and surgical treatment. Results from randomized studies.

Few randomized studies including a sufficient number of patients comparing different methods of loco-regional treatment have been performed on operable breast carcinoma. This review summarizes the findings after total mastectomy with or without lymph-node dissection and/or radiotherapy. There was no difference in survival or local recurrence rates between extended radical mastectomy and radical mastectomy or mastectomy plus loco-regional radiotherapy. The results after radical mastectomy with or without loco-regional radiotherapy are the same as after modified radical mastectomy. Simple mastectomy plus loco-regional radiotherapy offers the same prospects of survival as modified or radical mastectomy with or without loco-regional radiotherapy. In some studies loco-regional radiotherapy after various forms of total mastectomy reduced loco-regional recurrences, but did not affect overall survival. Preoperative radiotherapy seems to enhance survival prospects after modified radical mastectomy, but only time will tell if this effect will be sustained.

Breast Neoplasms↗
PubMed1984

Contemporary options in the operative treatment of breast cancer.

The past decade has witnessed many changes in the basic concepts and understanding of breast cancer. The classic radical mastectomy, which prevailed for almost 100 years, has given way to a less aggressive surgical approach that aims to provide a better quality of life without compromising survival. Modified radical mastectomy, simple mastectomy, and breast-conserving local excision are discussed.

Adult↗
PubMed1997

Outpatient definitive breast cancer surgery.

We attempted to show that surgical treatment of breast cancer, including axillary lymph node dissection with or without concomitant partial mastectomy (ALND), simple mastectomy (SM), and modified radical mastectomy (MRM) can be performed safely in an outpatient setting. The records of 100 consecutive women undergoing definitive breast cancer surgery by the authors between August 1994 and July 1996 were retrospectively reviewed. Average age was 54 +/- 10 years. Fifty patients were discharged the day of surgery, 44 were hospitalized, and 6 remained 2 or more days postoperatively. Outpatients were more likely to have undergone ALND or SM (42 versus 23 procedures) and more often completed surgery in the morning (36 versus 12); P < 0.05. Eight patients of 35 with MRM were discharged the same day. One patient was readmitted with a wound infection. There were no major complications or deaths. Ninety-four per cent of patients were discharged within 23 hours of surgery; half were discharged the same day. No complications occurred in outpatients, and there were no readmissions. For patients admitted overnight, no complications were detected during the overnight hospital stay. In conclusion, breast cancer surgery, from ALND to SM or MRM, can be safely and comfortably performed on an outpatient basis.

Adult↗
PubMed1986

[Local recurrence following surgery for breast cancer and its relation to the primary intervention].

UNLABELLED: 32 cases of local recurrence following curative mastectomy were operated between 1975 and 1984. The primary operation was: radical mastectomy n = 20, simple mastectomy n = 6, lumpectomy with axillary dissection n = 6. The rate of local recurrence amounted to: 4.8% (20 patients out of 416) after radical mastectomy; 6 out of 15 patients after simple mastectomy (2 were N1-cases); 6 out of 15 patients after lumpectomy (one case: N1). CONCLUSION: With regard to local recurrence radical mastectomy showed significant better results when compared with less radical operations.

Breast Neoplasms↗
PubMed1975

Radical mastectomy in the aged female.

Of 142 female patients over age 75 at The New York Hospital-Cornell Medical Center, 58 underwent radical mastectomy and 40 simple mastectomy for primary breast cancer. After five years, 19 per cent of the radical mastectomy group were cancer-free compared with 35 per cent of the simple mastectomy group. The gross five-year survival rates were 50 per cent and 47 per cent respectively. In the radical mastectomy group, when the axillary nodes did not show cancer at the time of operation, there have been no known recurrences and 70 per cent of the patients have survived at least five years. There was no surgical mortality. These findings support the view that until more controlled data are available, radical mastectomy is still the preferred therapy for primary breast cancer.

Age Factors↗
PubMed2006

Phyllodes tumors of the breast: a case series of 106 patients.

BACKGROUND: Phyllodes tumors (PTs) of the breast are rare, and their prognosis and treatment are still subject of discussion. The purpose of this study is to clarify therapeutic aspects and prognostic factors of this disease. PATIENTS AND METHODS: We retrospectively reviewed the medical records of 106 patients who had histologically confirmed PTs collected over a period of 10 years. RESULTS: The mean age was 39.5 years (14-71 years). The mean tumoral size was 83 mm (15-250). According to criteria of Azzopardi and Salvadori, tumors were classified into 3 groups: benign (62 cases, 58.4%), borderline (16 cases, 15%), and malignant (28 cases, 26.4%). Eighty-two patients (77.4%) were treated conservatively (62 benign, 11 borderline, and 9 malignant) and 24 (22.6%) by radical surgery (5 borderline and 19 malignant). For malignant PTs treated by enucleation or local excision with or without reexcision of the tumor bed, the 5-year overall and disease-free survivals were 28.5% and 15.6% versus 72.7% and 73.6% when the surgery was radical (mastectomy with or without axillary dissection) (P = .12 and P = .0022). For the other histotypes, this difference disappeared. The rate of recurrence was 12.2% (13) after a mean follow-up of 39 months (5 benign, 2 borderline, and 5 malignant). The treatment of recurrences consisted of radical mastectomy (8 cases), simple mastectomy (2 cases), and local excision in 3 cases. Eight patients developed metastases, 2 of whom after recurrences. The 5-year overall and disease-free survivals were 86.54% and 78%, respectively. In univariate analysis, age and recurrences are not of prognostic value for survival, whereas tumor size, histotype, necrosis, cytonuclear atypia, tumor margins, and number of mitosis were significant prognostic factors for survival. In a multivariate study, only cytonuclear atypia remained an independent predictor for survival. CONCLUSION: According to our results, we recommend for malignant PT a simple mastectomy, whereas for borderline and benign PT, treatment is based rather on wide excision passing in healthy tissue.

Adolescent↗
PubMed1978

Treatment of early breast cancer.

The early follow-up of patients treated by simple mastectomy alone or simple mastectomy combined with radical radiotherapy is presented. Both groups were well matched for age, menopausal status, duration of symptoms, size of tumour, and lymph-node involvement. There was no significant difference in survival of patients in the two groups at three years, but local recurrence was significantly more frequent (28%) in the mastectomy-alone patients. Early survival was not adversely affected by radiotherapy.

Age Factors↗
PubMed1982

Manchester regional breast study--5 and 10 year results.

Patients with early breast cancer (n = 1022) were treated between March 1970 and October 1975 in a prospective clinical trial. The results are presented after follow-up of 5-10 years. Clinical stage I cancer cases (n = 714) were randomly allocated to treatment by simple mastectomy and postoperative radiotherapy, or simple mastectomy alone. There was no statistically significant difference in overall survival between the two groups. There was a significant reduction in the frequency of local recurrence in those who received early postoperative radiotherapy compared with those who did not. Clinical stage II cancer cases (n = 308) were randomly allocated to treatment by simple mastectomy and postoperative radiotherapy or radical mastectomy alone. There was no statistically significant difference in survival or in the frequency of local recurrence between the two groups.

Adult↗
PubMed1978

Manchester regional breast study. Preliminary results.

1020 patients with early breast cancer were treated between March, 1970, and October, 1975, according to a prospective clinical trial. The results have been recorded after a follow-up of two to seven years. 713 cases of clinical stage-1 cancer were randomly allocated to treatment by simple mastectomy and postoperative radiotherapy, or simple mastectomy alone. There was no statistically significant difference in overall survival or in survival without distant metastases between the two groups. There was a significant reduction in the incidence of local recurrence in those who had received early postoperative radiotherapy compared with those who had not. 307 cases of clinical stage-11 cancer were randomly allocated to treatment by simple mastectomy and postoperative radiotherapy or radical mastectomy alone. There was no statistically significant difference in survival or in the incidence of local recurrence or distant metastases between the two groups.

Adult↗