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Biomedical subjects

F Campana

Publications and source records attributed to F Campana.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Primary epidermoid carcinoma of the breast. Clinical, histopathologic and prognostic study of 14 patients].

We reviewed the charts of 14 patients with epidermoid breast carcinoma, whether pure or associated with a minor glandular component. These patients were treated between 1970 and 1989 at the Institut Curie and represented 0.06% of all breast cancer patients treated during the same period. No clinical or radiological criteria could help to discriminate these forms from other types of breast cancer. Four out of 13 patients with initial axillary node dissection had nodal involvement. Various combinations of surgery and radiotherapy were used to treat these patients. One out of 14 hormone receptor levels was positive. Median survival was 54 months (9 months-144 months). Two patients had a local recurrence and 7 had metastasis. No event occurred beyond 5 years of follow-up. This suggest that the outcome of epidermoid breast tumors is closer to that of other epidermoid tumors, rather than to other types of breast cancer.

Adult↗
PubMed1992

[Breast cancer in men: incidence and types of associated previous synchronous and metachronous cancers].

Male breast cancer represents about only 1% of all breast cancers. We have analysed a retrospective, multicentric series of 404 patients, initially non-metastatic, with mean age of 63 years. The 5 and 10-year overall survival rates were 65 and 36% respectively. Sixty-eight patients developed secondary cancer. From ten patients who already presented with cancer (2.5%) 3 cases corresponded to prostatic cancer treated by estrogen. Four had synchronous cancer (1%). Three and eight patients respectively had a synchronous and metachronous contralateral breast cancer (2.7% of bilateral cancer). Forty-three other patients (10.6%) developed metachronous cancer. The main tumor types were: prostate (9), lung (6), colon and rectum (6), esophagus (4). Four patients developed various hematologic malignancies and 14 patients, various types of solid tumors. From these 43 patients, 27 died; 19 as a result of secondary cancer. This represents 9% of all deaths among the 404 patients. While the bilateral cancer rate is similar to women, the second cancer rate appears to be higher in men. From hematological malignancies, chemotherapy and radiotherapy do not seem to contribute to this high incidence of second cancer.

Aged↗
PubMed1991

Breast irradiation in the lateral decubitus position: technique of the Institut Curie.

Breast irradiation in the lateral decubitus (LD) position is a technique used at the Institut Curie for more than 30 years in the breast-conserving management of patient with breast cancer. This technique is described in detail in this article. The patient's position allows the breast to flatten over a support, hence providing a rather homogeneous thickness throughout the treated volume. Dose at mid-thickness on the beam axis can be easily determined from entrance and exit dose measurements. Disadvantages and advantages of the LD technique are discussed. We presently recommend this technique for patients with large breasts (more than 6 cm thickness in LD position).

Breast Neoplasms↗
PubMed1991

[Concomitant association of radiotherapy and chemotherapy in inflammatory breast cancer. Initial results of phase II trial].

Between 01/1986 and 12/1987, 15 patients displaying inflammatory breast carcinoma, were included in a phase II trial. The aim of the treatment was to increase the local response by the potentiation of radiotherapy by concomitant chemotherapy (continuous infusion 5 FU, vindésine, Cyclophosphamide). This treatment consisted of four series of radiotherapy: 18 Gy/10 fractions/12 days spaced by a 2-week rest period between series, to a total dose of 72 GY to the breast tumor. Chemotherapy was undertaken over the first 5 days of radiotherapy in each series. Two patients had metastatic disease (bone-liver). Seven patients had not responded to an initial standard chemotherapy treatment. Six patients were initially treated with the concomitant association. The treatment was very well tolerated by all 15 patients. Inflammation disappeared in all patients within 6 weeks after the beginning of the association. A tumor decrease was observed in all patients, complete in 60%. All 7 patients who had failed initial chemotherapy recurred 8 to 19 months after the association, despite a good response; 3 died of disease and 4 were in local or metastatic evolution on last follow up. The 6 patients treated initially with the association Radiotherapy/Chemotherapy were all alive with a 27 months median follow up (24-40). 2/6 mastectomies were performed: one for breast recurrence and one for persistent residual mass. In this latter patient histologic examination showed no residual active tumor. 4/6 patients have their breast preserved without sequelae. High local response rates were observed with the concomitant combination of radiotherapy and chemotherapy, specially when administered as initial treatment.

Adult↗
PubMed1990

[Treatment of borderline lesions and non-infiltrating carcinoma].

As mammography is increasingly prescribed systematically and mammography films are of better quality, diagnostic biopsies are performed in growing numbers, leading to the discovery of "borderline" histological lesions which were relatively rare a few years ago. The authors have studied the frequency and clinical presentation of these lesions. In patients with atypical hyperplasia simple monitoring is the rule since the short- and long-term effects of medical treatments are too uncertain for these to be recommended routinely. The finding at histology of lobular carcinoma in situ is regarded as indicating a high risk of cancer infiltrating both breasts, and in all but some special cases close supervision with 6-monthly clinical examination and annual mammography is advocated. Whether or not endocrine treatments reduce the incidence of infiltrating carcinoma is unknown. In patients with intraductal carcinoma mastectomy gives excellent results at the cost of a considerable loss of tissue. In view of the N.S.A.B.P. and Curie Institute experience, tumorectomy alone is not recommended because of the high risk of recurrence, but a conservative treatment (limited surgery followed by radiation) is permitted. Conservative treatment may also be attempted in Paget's disease without palpable tumour.

Breast Neoplasms↗
PubMed1990

[Mammoplasty combined with irradiation: conservative treatment of breast cancer localized in the lower quadrant].

Conservative radio-surgical treatment of breast neoplasms is often responsible for poor cosmetic results when the tumor is located in the lower quadrants. Since 1986, ten patients with such a tumor were treated at the Curie Institute by a combination of a superior pedicle mammaplasty and radiotherapy. The mammaplasty was bilateral in nine cases. Four patients were operated upon before radiotherapy, while the six others had preoperative radiotherapy. The average weight of the lumpectomy was 193 g, and its margins were always tumor-free. There were no locoregional recurrences (average follow-up time: 16 months). Symmetrization enabled us to obtain contralateral histological data. The cosmetic results were very good when surgery was performed before radiotherapy. When radiotherapy was performed first, the result was often slightly asymmetric, with a smaller irradiated breast. The only complication was partial areolar necrosis in one patient who had been heavily irradiated (85 grays). The combination of a mammaplasty and radiotherapy makes it possible to perform a large lumpectomy of the lower quadrants with good cosmetic results. The interest of this protocol in the extension of the indications for conservative treatments of breast neoplasms is discussed.

Adenocarcinoma↗
PubMed1990

[Role of magnetic resonance spectroscopy in the diagnosis of ischemic cerebrovasculopathy].

NMR is still considered essentially, in the field of ischemic brain vascular disease, an imaging method. On the contrary, Authors review MR-spectroscopy possibilities, emphasizing that by this method it is possible to achieve a complete and dynamic study of brain energy metabolism, and therefore to identify markers of cellular injury clearly more sensitive and precocious than MRI morphological findings. Moreover, this method allows to easily evaluate cerebral blood flow, pharmacologic treatment efficacy, effects of eventual metabolic abnormalities on ischemia's evolution.

Animals↗
PubMed1989

Presentation of axillary lymphadenopathy without detectable breast primary (T0 N1b breast cancer): experience at Institut Curie.

Between 1960 and 1985, 31 patients presented to Institut Curie with isolated axillary lymphadenopathy, of probable metastatic origin from the breast, but without clinical or radiological evidence of a breast tumor and no other primary tumor. The mean age was 54.6 years (range 39-79 years). Histological diagnosis was obtained by axillary surgery (22 cases), drill biopsy (6 cases), and cytology (3 cases). All slides were reviewed for the present study. Treatment consisted of axillary surgery followed by radiotherapy in 22 patients, radiotherapy followed by axillary surgery in 6 patients, radiotherapy followed by modified radical mastectomy in one patient, and radiotherapy alone in 2 patients. Systemic adjuvant treatment was given to 11/31 patients. The median follow-up was 9 years (range 2-26 years). Eight recurrences have appeared. Four patients recurred in the breast only (mean time to relapse: 112 months, range 63-162 months). The four other patients recurred both in breast and/or axilla (mean time to relapse: 23 months, range 7-46 months). Nine patients have developed distant metastases, of whom three also had locoregional recurrence. Among the 11 patients who had had systemic treatment, 5/11 had recurrence or metastases. The overall 5 and 10 year actuarial survival rates were 76 and 71%, respectively. The metastasis-free 5 and 10 year actuarial survival rates were 73 and 71%, respectively. Axillary metastases without clinical or radiological evidence of a primary breast tumor represents a discrete clinical entity, the prognosis of which appears to be better than that of clinical invasive breast cancer with associated lymph node involvement.(ABSTRACT TRUNCATED AT 250 WORDS)

Axilla↗
PubMed1989

Prognostic value of hemoglobin concentrations and blood transfusions in advanced carcinoma of the cervix treated by radiation therapy: results of a retrospective study of 386 patients.

A retrospective study was carried out on 386 patients with advanced cervical carcinomas treated with radiation therapy between 1973 and 1983. The influence of hemoglobin concentrations and blood transfusions before and/or during treatment on the occurrence of distant and/or local regional failures were examined in a univariate and multivariate analyses. In the multivariate analysis hemoglobin concentrations were prognostic only during treatment and patients with at least one value below the threshold of 10 gm% had a significantly higher risk of local regional failure than the patients with all their values above the threshold. Moreover 70% of these high risk patients had less than half of their values below the threshold. It is possible that blood transfusions might be beneficial when given before treatment. However, although it was not significant, blood transfusions given during treatment tended to be an adverse prognostic factor suggesting that blood transfusions might not have completely offset acute anemia prior to transfusion. Our study suggests that anemia during treatment, even of short duration might be detrimental to patients.

Adenocarcinoma↗
PubMed1989

Prognostic factors of breast recurrence in the conservative management of early breast cancer: a 25-year follow-up.

Between 1960 and 1980, 518 patients with T1, T2, N0, N1a, invasive breast cancer were treated by limited surgery at Institute Curie with (183 patients) or without (335 patients) axillary node dissection, followed by radiation therapy to breast and nodes. Median follow-up was 8.6 years (1.3 to 25 years). Fifty-six breast recurrences occurred, including 49 breast recurrences alone, 3 simultaneous breast and node recurrences, and 4 simultaneous breast recurrences and metastasis. Five-year, 10-year, and 15-year actuarial risks of breast recurrences were 7 +/- 1%, 11 +/- 1.5%, and 18 +/- 3%, respectively. Univariate analysis of 14 clinical and pathological prognostic factors revealed that local control in breast was significantly impaired by young age, premenopausal status, inadequate gross surgical excision, extensive ductal in situ component, and endolymphatic extension. On multivariate analysis with a Cox regression model, the most important contributors to local breast control in order of importance were age (p less than 10(-4), relative risk = 2.44), adequacy of surgery (p = 0.003, relative risk = 2.78), and endolymphatic extension (p = 0.03, relative risk = 2.98). The 5-year actuarial survival rate following breast recurrence was 73%, and was significantly worse when breast recurrence occurred in the first 3 years after treatment: 44% versus 87%, respectively (p less than 0.01). This study confirms the relationship between young age and low breast control rates, and demonstrates the importance of adequate initial surgical procedures. It emphasizes the adverse prognosis of early breast recurrences as compared to the relatively favorable outcome of late recurrences.

Adult↗
PubMed1987

Paget's disease of the nipple without detectable breast tumor: conservative management with radiation therapy.

Between 1960 and 1984, 20 selected patients with Paget's disease of the breast confined to the nipple were treated conservatively with radiotherapy alone (17/20 pts) or limited surgery and radiotherapy (3/20 pts). Median follow-up was 7.5 years. No patients died of breast disease. Three patients had recurrence in the treated breast, and were treated by mastectomy. All recurrences were located in the nipple or areola and were all Paget's disease, without associated intraductal or invasive carcinoma. No axillary node recurrences occurred. The actuarial 7-year probability of living free of disease with breast preserved was 81%. Among the 15 patients who had a minimum follow-up of 3 years, without recurrence, 12 (80%) had a good cosmetic result. These results suggest that radiation therapy could be an effective alternative to radical surgery in the treatment of patients with Paget's disease of the nipple without concomitant breast tumor.

Adult↗
PubMed1987

Medullary breast carcinoma: the role of radiotherapy as primary treatment.

The results are reported of a selected series of 41 patients with medullary carcinoma of the breast, treated with primary radiotherapy with (24 patients) or without (17 patients) adjuvant chemotherapy. Complete responses to radiotherapy occurred with moderate doses (67% of the patients had a complete response after a dose of 55-60 Gy) and were increased by the addition of an irradiation boost. The 6-year actuarial free of local recurrence survival, metastase-free survival and survival rates were 86, 83, and 83%, respectively. The 6-year actuarial probability of living with breast preserved was 72%. Recurrences and survivals were not influenced by the tumor size or clinical axillary node status. Adjuvant chemotherapy had no effect on the rate of recurrence or survival.

Adult↗
PubMed1987

[Paget's disease of the nipple without any associated mammary tumor clinically or radiologically detectable. Apropos of 51 cases treated at the Curie Institute].

Between 1960 and 1984, 51 patients with Paget's disease of the nipple, with no concomitant palpable or radiological breast tumour, were treated at the Institut Curie. The diagnosis was made in all cases through a simple biopsy of the nipple and/or the areola. All slides were reviewed for the present study. 20/51 patients were treated conservatively, with external radiotherapy alone (17/20 pts), or limited surgery and radiotherapy (3/20 pts). The mean age was 54 years (range 40 to 80). The median follow-up was 7.5 years. No patients died of breast disease. Three local recurrences occurred and were treated by mastectomy. All were located in the nipple or areola and were Paget's disease without intraduct or invasive carcinoma. The actuarial probability of living 4.5 years free of disease when the breast is preserved with a good cosmetic result is 81%. 31/51 patients underwent mastectomy; 30 a modified mastectomy, 1 a simple mastectomy. The mean age was 66 years (range 55 to 90). Associated intraduct carcinoma was found in 30/31 microscopic examinations. No axillary node invasion was found after dissection of the axilla. In the group treated by surgery, the median follow-up was 5 years. No patient died of breast disease. No chest wall recurrence occurred. The 5 years disease-free survival rate was 87%. This retrospective non randomized study of 51 patients treated for Paget's disease of the nipple suggests that radiotherapy is a valuable alternative to mastectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Persistant mucosal ulcerations: a rare complication of toxic epidermal necrolysis].

INTRODUCTION: Sequels can be observed in toxic epidermal necrolysis. Persistence of mucosal ulcerations is not a classical complication of this disease. We describe two case reports of mucous membrane ulcerations (oral and genital) which have remained many months after the acute phase of toxic epidermal necrolysis. CASE REPORTS: Case 1. A little girl, 9 years old, was referred for a chronic and painful ulceration of the vulva that had appeared 9 months earlier during a toxic epidermal necrolysis. She presented a clearly crircumscribed vestibular ulceration. The mucosal biopsy was refused by the family. The genital erosion persisted more than one year after the acute phase. Case 2. A 73 year-old man was referred for a persistent and clearly circumscribed lingual ulceration, 9 cm in diameter. This chronic ulceration had appeared 3 months earlier, during the acute phase of a toxic epidermal necrolysis. The skin biopsy specimen, with histologic and direct immunofluorescence analysis, did not disclose any specific anomalies. After a period of clinical observation, intralesional injections of corticosteroids were decided and ulceration progressively decreased in 13 months. DISCUSSION: Complications of toxic epidermal necrolysis mainly occur at the acute phase. The most well documented sequelae are ophthalmological lesions. The most frequent cutaneous sequelae are cutaneous pigmentary changes and nail dystrophy. We report two observations of persistent mucous membrane erosions many months after the acute phase of toxic epidermal necrolysis. The pathophysiology of this complication, is rarely described and still remains unclear.

Aged↗
PubMedDate not supplied

Mortality rates and antihypertensive therapy in extreme old age.

The impact of hypertension on survival in extremely old age has shown different features in different studies, with equal or lower mortality rates in hypertensive patients and lower reduction of risk in treated patients. In a population (n=414) of old community dwellers (mean age 88.4 years) the prevalence of hypertension was 52.2%. Hypertensive patients presented a lower mortality rate (14.2 per 100 person-years) as compared to the general population (15.4) and to non-hypertensives (16.6). Hypertensives were divided into four groups according to treatment. Best survival was shown by patients under treatment with antihypertensives alone (9.8) or in association with diuretics (9.9), and worst survival by patients under a diuretic-based treatment (25.1). These data were confirmed by multivariate analysis. The better survival of hypertensive very old people could be related to the use of a proper pharmacotherapy.

Journal Article↗
PubMedDate not supplied

Topical superoxide dismutase reduces post-irradiation breast cancer fibrosis.

Fibrosis following breast radiotherapy for mammary cancer is a frequent undesired effect with objective (esthetic) and subjective (pain) consequences. Forty-four patients with clinical radiofibrosis following conservative treatment of breast cancer were evaluated for the local antifibrosis effect of copper zinc superoxide dismutase [SOD(Cu/Zn)]. Extracted SOD(Cu/Zn) in a concentration of 3,600 units/mg was applied as ointment to the fibrotic affected area, b.i.d. for 90 days, in a total dose of 40 mg. The radiofibrosis intensity was scored on the basis of clinical criteria (pain and the fibrosis area) before and after SOD(Cu/Zn) treatment. SOD(Cu/Zn) was found to be effective in reducing radiation induced fibrosis by a lowering pain score in 36/39 patients and a decrease of the fibrotic area size in half cases, after 6 months. The intensity and changes of breast fibrosis were assessed also by mammography and, for the topographical distribution of subcutaneous temperature, by infrared thermography. Mammography density suggested decreased fibrosis in one third of patients. Thermography showed that fibrosis was accompanied by two zones clinically indistinctive: a central area with maximum thermal activity, called "Maximal Thermic zone" (MTZ) and a peripheral area with less thermal activity but higher than in the surrounding normal tissue, "Transitional Thermic Zone" (TTZ). Both MTZ and TTZ were significantly decreased in 36/44 patients after SOD(Cu/Zn) treatment. Clinical changes persisted all along the study. Treatment was well tolerated except for one case of local allergic reaction, and no important side effects. Molecular mechanisms involved are discussed. Further studies are running to confirm and explain these results.

Aged↗
PubMedDate not supplied

Medullary breast carcinoma: prognostic implications of p53 expression.

Medullary breast carcinoma (MBC) is a rare pathological type of breast cancer. The rate of p53 protein accumulation is higher in MBC than in common invasive ductal carcinoma. Whether this particular feature of MBC influences the outcome after treatment is unknown. We retrospectively analyzed the characteristics, treatment and outcome of 71 patients with MBC treated between 1981 and 1996. The median age was 51 years (range 27-81) and the median clinical tumor size was 25 mm (range 0-70 mm). Breast-conserving treatment was offered when possible: 55 patients had undergone a tumorectomy and radiotherapy while 16 patients had undergone a mastectomy. p53 protein accumulation was determined by immunohistochemistry on paraffin-embedded tumor specimens from 58/71 samples available for this study. The median follow-up for the 56 survivors was 113 months (range 30-241). The 10-year survival and metastasis-free survival rates were 81% and 81.4%, respectively. The local recurrence rate was 16.4%. The two factors predicting outcome were pathological axillary node involvement in the 60 patients who underwent axillary dissection and adjuvant chemotherapy. p53 accumulation was found in 33/58 patients (57%). p53 status was not predictive of survival nor of distant or local recurrences. We confirm that medullary breast carcinoma has a favorable prognosis despite its aggressive pathological features. p53 protein accumulation, found in the majority of MBCs, was not related to outcome.

Adult↗