Oxygen transport and consumption during acute hemodilution.
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Biomedical subjects
Publications and source records attributed to F E Gump.
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BACKGROUND: We thought that observation for patients with lobular carcinoma in situ (LCIS) had been generally accepted by the mid-1980s. A questionnaire mailed to oncologic surgeons in 1988 revealed that 33% of the respondents still advised unilateral mastectomy, although a slim majority (54%) advised observation. New studies have been published in the intervening 8 years, and we decided it would be worth recirculating the 1988 questionnaire. METHODS: The identical questionnaire was mailed to members of the same oncologic societies (Society of Surgical Oncology [SSO] and Society for the Study of Breast Disease), but changes in membership necessitated new mailing lists. RESULTS: Observation has yet to be universally accepted by the oncologic community, but at this time 85% of the respondents suggest it as the preferred option for their patients. CONCLUSIONS: Recent studies have questioned some of the tenets laid down by Haagensen in 1978, but it appears clear that his formulation of LCIS as a marker of increased risk continues to gain ground over the original concept of inevitable progression to invasive disease.
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Breast preservation has focused attention on the extent and distribution of cancer in the breast. Recent studies suggest that there is spread from the primary tumor rather than a random distribution of cancer throughout the breast. As a result the term multicentric has largely been replaced by multifocal. Evidence that there is a geographic relationship of secondary deposits to the primary lesions opens the way to wide excision as definative treatment for selected patients with both invasive and in situ breast cancer.
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