[Telethermography and breast cancer].
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Biomedical subjects
Publications and source records attributed to A F Montoro.
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Alternatives to the traditional hormone receptor dosages for prognostic evaluation and clinical approach to breast cancer have been proposed for immunohistochemical determinations. For correlation purposes, such procedures were compared in 37 patients presenting 5 to 15 years of survival. Considering 30 fm/mg as the positivity index, the disagreement between both methods reached 35.1% with estrogen and 48.5% with progesterone receptors. When the positiveness level was changed to 20 fm/mg, the discrepancies were reduced to 32% with ER and increased to 57% with PgR. This study leads us to not recommend the immunohistochemical method applied to paraffin sections as an alternative procedure to the dextran-charcoal dosage for prognosis and therapeutic management of mammary carcinoma.
Occult carcinoma of the breast is characterized as a diagnosis made when the finding of axillary metastasis precedes the identification of the primary mammary lesion. This concept must be distinguished from subclinical breast cancer, in which a non-palpable tumor is discovered through radiological image. In 1975, a 56 years old patient presented an axillary metastatic lesion not detected by a conventional mammogram, but revealed by specialized equipment. After a modified radical mastectomy performed at that time, she has remained asymptomatic for 14 years. In 1985, a 51 years old patient, had an axillary clearance after a diagnosis of a malignant lymph node without the identification of the primary lesion on her homolateral breast, in spite of several tests. After 40 months, during her frequent follow-up, a small lump was identified by mammography. The patient underwent a quadrantectomy followed by radiotherapy and is asymptomatic after 2 years. These 2 cases, added to others mentioned in international literature, allow us to consider occult breast carcinoma as a particular type belonging to the special category of Unknown Primary Tumors (UPT), in which the biologic aspects and prognostic index authorize a less aggressive management than is usually accepted for the UPTs.
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