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At least 145 records · Page 8Linked to original sources

PubMed1996

Local anaesthesia for major general surgical procedures. A review of 116 cases over 12 years.

Between 1980 and 1992, 116 patients had either a simple mastectomy (32) or intra-abdominal procedures (84) under local anaesthesia (0.5-1% lignocaine with 1:200 000 adrenaline). A wide variety of general surgical procedures were feasible using only supplementary intravenous sedation (54%). Complications were uncommon and related to surgical procedure (three incorrect diagnoses, three procedures impossible) rather than the anaesthetic technique. There were no anaesthetic toxicity or postoperative problems. Local anaesthesia is extremely safe and facilitates larger surgical procedures than is generally appreciated.

Abdomen↗

PubMed1992

Phyllodes tumor in a patient with a preexistent fibrocystic disease.

A phyllodes tumor appeared at the site of a resected fibrocystic disease focus. Administration of danazol resulted in temporary regression, but the tumor resumed growth. Relative hyperestrogenism also continued to increase in spite of continued long-term administration of danazol. After 12 months a simple mastectomy was performed. Most of the resected mass consisted of the phyllodes tumor, but it also contained fibrocystic disease.

Adult↗

PubMed1987

Male breast carcinoma. II. A study of the total material reported to the Swedish Cancer Registry 1958-1967 with respect to treatment, prognostic factors and survival.

The complete material of male breast cancer, 166 cases, reported to the Swedish Cancer Registry in 1958-1967 is described and analyzed concerning different prognostic parameters, treatment methods and survival. Age at diagnosis, axillary lymph node status and tumour size all had significant prognostic importance in a multivariate analysis with axillary lymph node status as the strongest factor. Histologic malignancy grade was strongly correlated to axillary lymph node status and tumour size and thus to prognosis, but did not seem to be an independent prognostic factor. The primary treatment methods were quite heterogeneous and were obviously influenced by both age of the patient and clinical tumour status. No significant correlation was found between type of primary treatment and survival, but due to the retrospective nature of the study no definite conclusion could be drawn. Radical mastectomy seemed, however, to give fewer loco-regional recurrences than both modified radical mastectomy and simple mastectomy. Very few patients in the present series had received radiation therapy in adequate doses. The material gave some indications that orchiectomy might prolong survival in patients with recurrent or generalized disease.

Age Factors↗

PubMed2006

Painless breast lump in an elderly woman. Secretory breast carcinoma in an elderly woman.

Secretory breast carcinoma is a rare breast cancer. It occurs in all age groups, with the majority of patients being adults. It is a rare occurrence in elderly (>50 years) patients; only 5 cases have been reported in this patient group in the English literature. It is even rarer in males, with only 15 cases reported in the world literature. Ultrasonographic findings may resemble other well-circumscribed breast carcinomas as well as some benign masses, including fibroadenomas. We present a case of a 60-year-old woman who had a painless lump in her right breast. The tumor was ulcerating through the skin. Axillary lymph nodes were also palpable. Simple mastectomy was performed and the histopathologic findings revealed secretory carcinoma of the breast.

Adenocarcinoma↗

PubMed1998

[Therapy concept in phyllodes tumors of the breast].

The data of 22 women with a phyllode tumor of breast operated in our department from 1980 to 1997 were analysed. 11 benign, 7 borderline and 7 malign phyllode tumors were found in accordance to WHO-classification. In conclusion diameter of tumor is a relevant prognostic factor beside histologic classification. Therefore local excision is recommended for benign and borderline phyllode tumors smaller than 5 cm. A safety distance of 1 cm is claimed. Benign or borderline lesions greater than 5 cm and all malign require a simple mastectomy. Only recurrence smaller than 5 cm after excision of benign and borderline phyllode tumor should excised once more. Metastasis have to be cured by surgical therapy.

Adolescent↗

PubMedDate not supplied

C-erbB-2, CEA and CA 15.3 serum levels in the early diagnosis of recurrence of breast cancer patients.

UNLABELLED: C-erbB-2, CEA and CA 15.3 serial serum determinations were performed in 250 patients (follow-up: 1-4 years, mean 2.5 years) with primary breast cancer and no evidence of residual disease (NED) after radical treatment (radical mastectomy or simple mastectomy and radiotherapy). Ninety-five patients developed metastases during follow-up. RESULTS: Abnormal c-erbB-2, CEA and CA 15.3 serum levels (> 20 U/ml, > 10 ng/ml or > 60 U/ml, respectively) prior to diagnosis were found in 28.4%, 31.6% and 46.3% of the 95 patients with recurrence, with a lead time of 4.2 +/- 2.4, 5.0 +/- 2.5 and 4.6 +/- 2.7 months, respectively. One of the tumor markers was the first sign of recurrence in 69.5% of the patients. Tumor marker specificity was 100% with levels lower than the cut-point in all 155 patients without recurrence. Tumor marker sensitivity was clearly related to the site of recurrence, with the lowest sensitivity found in locoregional relapse and the highest in patients with liver or bone metastases. C-erbB-2 sensitivity in early diagnosis was significantly higher in patients with c-erbB-2 overexpression in tissue (10/12, 83.3%) than in those without overexpression (1/34, 2.9%) (p = 0.0001). Likewise, higher levels of both, c-erbB-2 and CA 15.3 at diagnosis of recurrence, higher sensitivity in early diagnosis of relapse and a higher lead time were found in PgR+ patients (CA 15.3) or in PgR- patients (C-erbB-2) (p < 0.015). In conclusion, tumor markers are useful tools for the early diagnosis of metastases, being the first sign of recurrence in 69.5% of patients with relapse (76.3% in patients with metastases).

Biomarkers, Tumor↗

PubMed2002

The possibilities of surgical cover of skin defect in locally advanced breast cancer.

Three types of surgical procedure were applied to cover skin defect in locally advanced breast cancer after simple mastectomy. The skin defect was impossible for primary suture. In four cases we used latissimus dorsi myocutaneous flap with a very good effect. In two cases skin flap from the abdomen was used, and one case skin graft. The female patients survived 2.1 years with better quality of life.

Aged↗

PubMed2003

[Anesthesia for a patient with Kartagener's syndrome undergoing ambulatory bilateral breast cancer surgery].

Kartagener's syndrome is an inherited disease characterized by a triad of symptoms, bronchiectasis, situs inversus and sinusitus. We report a case of a 53-year-old woman with the syndrome who received bilateral simple mastectomies and axillary lymph node dissections on ambulatory basis. She received antibiotic treatment until the day of surgery. She was admitted to our day surgery unit with productive cough and rales on both lungs on the day of surgery. General anesthesia was induced and maintained with propofol, fentanyl and vecuronium. Laryngeal mask airway (LMA) was placed. She received rectal diclofenac and bupivacaine infiltration into surgical field for pain relief. During pressure controlled ventilation, EtCO2, blood pressure and heart rate increased and SpO2 decreased gradually. These symptoms were resolved after resumption of spontaneous ventilation. She coughed out phlegm in LMA during surgery. The sputa were sucked out using bronchofiberscope. She made an uneventful recovery although she had productive cough preoperatively. She was discharged from the hospital without respiratory complication after overnight observation.

Ambulatory Surgical Procedures↗

PubMed2003

[Conservative surgery for ductal carcinoma in situ of the breast].

BACKGROUND: The conservative surgery is considered currently the treatment of choice for the carcinoma of the breast in the initial stage. METHODS: From 1993 to the 2000, 46 patients (median age 52 years) affected by intraductal carcinoma of the breast, have been submitted to surgical intervention. In 10 cases (21,7%) a palpable mass was observed (mean dimension of 1.3 cm). In 36 cases (78.3%) non palpable lesions were identified by mammography (26 microcalcifications and 10 non palpable masses). All patients have been treated after stereotactic preoperatory mammographic localization of the lesions. 15 simple mastectomies, 11 mammary resections without radiotherapy and 20 mammary resections followed by radiotherapy have been performed. No patient was submitted to axillary dissection. The radiotherapy has been administered with a boost of 50 Gy on the breast. RESULTS: At a 36 months median follow-up all the patients are alive and no local recurrence or distant metastases has been observed. CONCLUSIONS: The treatment of choice is the local resection of neoplasm followed by radiotherapy.

Adult↗

PubMed2003

[A case of advanced breast cancer with multiple lung, bone and lymph node metastases successfully treated with 5'-DFUR alone].

A 78-year-old female patient with locally advanced breast cancer, bleeding from a deep ulcer, and with multiple bone, lung and distant lymph node metastases was successfully treated with 5'-DFUR alone. She was at first treated with docetaxel + 5'-deoxy-5-fluorouridine (5'-DFUR) + tamoxifen, but they were discontinued because of deep venous thrombosis. She underwent simple mastectomy due to periodically recurring bleeding and infection. After administration of 5'-DFUR alone, a decrease of abnormal accumulation on a bone scintigram was obtained in 10 months, the lung metastases were diagnosed as being in complete remission (CR) at 11 months and the lymph node metastases were diagnosed as being in CR at 14 months. These states have continued to the present. The administration of 5'-DFUR alone is suitable for tumor dormancy in some cases.

Aged↗

PubMed1992

[Angiosarcoma of the breast: 4 case reports and review of the literature].

Four cases of angiosarcoma of the breast, including three previously unpublished, form the starting point for a brief descriptive review of this extremely rare but fearsome tumour which accounts for only 0.04 per cent of breast malignancies. The contrast between the initially totally benign clinical appearance of this sarcoma and the dramatic prognosis of its advanced or metastatic forms against which adjuvant chemotherapy remains of only relative usefulness, leads the authors to chiefly discuss a diagnostic approach likely to speed recognition (histological diagnosis) and treatment (simple mastectomy) of a tumour with two troublesome features: its powerful metastatic potential being matched only by its extreme rarity which may cause clinicians, radiologists and histopathologists to use valuable time.

Adult↗

PubMedDate not supplied

Isolated breast mucormycosis.

Mucormycosis is unusual in surgical practice. Awareness of the classical findings leads to early detection. Excisional therapy whenever possible along with systemic antifungal treatment is the key to successful outcome. A 70 year old female, a known case of diabetes mellitus and chronic obstructive pulmonary disease, on inhalational steroids and oral hypoglycemic agents, presented to us with complaints of sudden onset pain, redness and swelling of left breast. A diagnosis of severe mastitis was made and a release incision was taken. The entire breast became gangrenous in next 24 hours and simple mastectomy had to be performed as a life saving measure. Histopathology revealed mucormycosis of breast. To the best of our knowledge this is the first reported case of mucormycosis of breast in the English literature.

Aged↗

PubMedDate not supplied

[Mastitis with plasmacytes].

The paper reports on a case of mastitis with plasmocytes, with a clinical picture of acute suppurative inflammation, in a 49-year-old woman. After establishing the diagnosis by histologic examination and alleviation of the acute phenomena, simple mastectomy was applied. The anatomopathological, clinical and therapeutical data of the mastitis are discussed.

Acute Disease↗

PubMed1988

Breast cancer--the need for early diagnosis.

A retrospective study was undertaken of 265 women with breast cancer treated at the Department of Surgery, Toa Payoh Hospital, Singapore, during 8 years from 1977 to 1985. The average patient was aged 51.0 years, with a tumour 4.9 cm in diameter, staged at T2aN1bMO (Stage II). In comparison with an earlier series from the same Unit, an increase in the number of younger patients was noted, although overall a larger proportion of 'early' cases (TNM Stage I) was found. In contrast to recent western series, breast cancer in Singapore is diagnosed at a later stage and generally unsuitable for conservative treatment by lumpectomy and radiotherapy. The standard treatment was modified radical mastectomy, or simple mastectomy with axillary clearance, followed by Radiotherapy if ipsilateral axillary lymphnodes were histologically involved.

Age Factors↗

PubMed1986

Primary malignant fibrous histiocytoma of the breast.

Clinical, light microscopic, electron microscopic and immunocytochemical features of 4 cases (3 women and 1 man) of primary malignant fibrous histiocytoma (MFH) of the breast are presented. The literature is reviewed and the diagnosis and treatment discussed. The good outcome is stressed and local excision or simple mastectomy recommended as appropriate treatment.

Aged↗

PubMedDate not supplied

Angiosarcoma of the breast: report of two long-term survivals.

Angiosarcoma of the breast is a rare mesenchymal malignancy with a poor prognosis. One hundred sixty-four cases have been reported in the literature with 19 five-year, and 7 ten-year disease-free survivals. Two new cases of angiosarcoma of the breast are presented here, with disease-free survivals of five and ten years. In most series reviewed, angiosarcoma of the breast demonstrates as a rapidly fatal disease. Because axillary lymph node metastasis is rare, simple mastectomy with wide surgical margins is the procedure of choice. The mammographic and histologic findings may appear deceptively benign. A correlation exists between the histologic characteristics and the prognosis. Although there have been reports of increased survival with Actinomycin D, adjuvant therapy has failed to significantly alter the course of the disease in most series.

Adult↗

PubMed1985

Evaluation of effects of levamisole and surgery on canine mammary cancer.

Three hundred and forty-five dogs with mammary tumors were initially evaluated for study. One hundred and forty-four dogs with untreated malignant mammary tumors (136 adenocarcinomas, 5 malignant mixed, 3 sarcomas) were selected for study. All dogs were clinically staged and stratified on the basis of tumor volume and body weight. Dogs were randomized to either a radical mastectomy or simple mastectomy group, and then further randomized to a levamisole or placebo group. There was no significant difference in either survival time or cancer-free survival time between the surgery groups or between the levamisole and placebo groups. The most significant prognostic factor was tumor volume; dogs with tumors less than 41 cc had significantly enhanced survival time (p = 0.0007) and cancer-free survival time (p = 0.0005).

Animals↗

PubMed1969

[Therapy of breast cancer].

Report about 97 patients with 103 operations of cancer of breast. I used always restricted methods: 23 segment resections, 20 simple mastectomies, 60 enlarged mastectomies. The axillary glands were not extirpated. All patients got after operation an energy radiotherapy. If there were still production of estrogen hormone, the ovaries were treated by x-rays or by extirpation. The 5 year survival rate for all cases is 69.5%, the 10 year rate 39.6%. The 5 year survival rate of patients of stage I and II (Steinthal) is 81.8%, the 10 year rate 54.8%. Steinthal III-patients have a five year rate of 33% and a 10 year rate of 6%.

Adult↗