Resection of locoregional recurrences was performed after mastectomy in 50 cases in the period 1961-1974. An incidence of 2% to 35% is reported for such recurrences, which are due to a variety of factors. In the present series, attention was directed to age at mastectomy and at recurrence, size of primary tumour, presence of axillary metastases, and details of menarche, menopause and pregnancy. Mean age at mastectomy was 50 yr and at recurrence 53 yr. Tumour diameter ranged from 2 to 5 cm in 73% of cases. Lympho node metastases were present in 42%. In 80%, the recurrence was paracicatricial, in 13% parasternal, and in 7% axillary. Treatment consisted of resection, radiochemotherapy or endocrino-ablative management.

Adult↗

PubMed1974

[Neoplasm incidence in the surgery of the aged. Analysis of cases].

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Age Factors↗

PubMedDate not supplied

Dynamic helical CT of breast tumors.

PURPOSE: The purpose of our study was to test dynamic helical CT (hCT) in the evaluation of breast tumors. METHOD: Thirty-six patients with 39 suspected lesions underwent breast hCT before and 1, 3, and 8 min after intravenous contrast medium administration. A marked enhancement (> or = 100%) at 1 or 3 min without increase at 8 minutes was considered as the primary indicator for malignancy. Twenty carcinomas, one metastatic non-Hodgkin lymphoma, six fibroadenomas, and six other benign findings were histologically assessed. Six cases had negative fine needle aspiration cytology and at least a 2 year negative follow-up. RESULTS: hCT showed a 100% sensitivity and 83.3% specificity. Considering carcinomas and fibroadenomas, significant differences were found for the percent enhancement at 1 min (p = 0.002) as well as for the density increase or decrease at 3 versus 1 min (p = 0.0035), at 8 versus 1 min (p = 0.0027), and at 8 versus 3 min (p = 0.0180). CONCLUSION: hCT proved to have a high diagnostic efficacy in evaluating breast tumors. Even though it involves some exposure to radiation, it should be considered in patients in whom MR is contraindicated.

Adult↗

PubMedDate not supplied

Localization of the sentinel lymph node in breast cancer by combined lymphoscintigraphy, blue dye and intraoperative gamma probe.

Axillary lymph node status represents the most important prognostic factor in patients with operable breast cancer. A severe limitation of this technique is the relatively high rate of false negative sentinel lymph nodes (>5%). We studied 284 patients suffering from breast cancer; 264 had T1 tumors (16 T1a, 37 T1b and 211 T1c), while 20 had T2 tumors. All patients underwent lymphoscintigraphy 18-h before surgery. At surgery, 0.5 mL of patent blue violet was injected subdermally, and the sentinel lymph node (SN) was searched by gamma probe and by the dye method. The surgically isolated SN was processed for intraoperative and delayed examinations. The SN was successfully identified by the combined radioisotopic procedure and patent blue dye technique in 278/284 cases (97.9%). Analysis of the predictive value of the SN in relation to the status of the axillary lymph nodes was limited to 191 patients undergoing standard axillary dissection irrespective of the SN status. Overall, 63/191 (33%) identified SNs were metastatic, the SN alone being involved in 37/63 (58.7%) patients; a positive axillary status with negative SN was found in 10/73 (13.7%) patients with metastatic involvement. In T1a-T1b patients the SN turned out to be metastatic in 9/53 patients (17.0%). In 7/9 patients the SN was the only site of metastasis, while in 2/9 patients other axillary lymph nodes were found to be metastatic in addition to the SN. None of the 44 patients in whom the SN proved to be non-metastatic showed any metastatic involvement of other axillary lymph nodes. Our results demonstrate a good predictive value of SN biopsy in patients with breast cancer; the predictive value was excellent in those subjects with nodules smaller than 1 cm.

Adult↗

PubMedDate not supplied

Different sites and modes of tracer injection for mapping the sentinel lymph node in patients with breast cancer.

Several studies have been published describing the techniques of identification of the "sentinel lymph node" (SN). There are marked differences in the techniques used by different investigators. Although agreement exists about the tracer particle size and the volume of injection, it is unknown what is the best site where to inject the tracer or the vital dye. The aim of the present study was to define the influence of different sites of injection on imaging of the lymphatic ducts and their SNs. We performed a pilot study in 30 consecutive patients with breast cancer who underwent SN biopsy by means of radioguided surgery and vital blue dye mapping. The patients were divided into six groups of five patients each; each patient was given a subdermal (ID) or peritumoral (IP) injection of radiotracer (300 microCi in 150 mL of 99mTc-HSA microcolloids; Albures, Amersham Sorin) above the tumor site in order to localize the SN. After the identification of the SN, a second injection of radiotracer was performed, which was different in each patient subset. In some cases more than one lymph node appeared on the lymphoscintigraphic scans after the second injection of radiotracer. When the peritumoral route was used it took longer to visualize the lymphatic pathways. For the ID route, injection at the exact skin projection over the tumor is optimal. Internal mammary lymph nodes were identified by both IP (2) and ID (1) injection, irrespective of the quadrant in which the tracer was injected. Our findings support the hypothesis of a precise topographic correspondence between the primary tumor and its specific SN. The subdermal route is more accurate than the intraparenchymal route, as it allows faster identification of the lymphatic vessels and SN. We believe these observations should be taken into account for the proper selection of the injection site of either vital dye or radiopharmaceuticals.

Adult↗

PubMedDate not supplied

Concomitant radiation-doxorubicin administration in locally advanced and/or metastatic soft tissue sarcomas: preliminary results.

Doxorubicin was administered by continuous infusion at a dosage of 12 mg/sqm/day for 5 days concomitantly with radiation treatment (150 or 200 cGy/day for trunk or extremity lesions, respectively) for 5 days. The 5-day cycles were repeated every 3 weeks. Seventeen patients, 5 of whom were pretreated, entered the study; all were assessable for toxicity and 15 for response. The overall objective response rate was 46% (7/15): 1 complete and 6 partial responses. Response rate reached 54% in only non-pretreated patients (6/11) and 75% in patients with PS less than or = 2 (6/8). No disease progression was observed during treatment. The median duration of complete or partial responses was 28 weeks (range 5-86). Toxicity was low and treatment very well tolerated. In our preliminary analysis, the response rate obtained with this combined chemo-radiotherapic regimen was encouraging and the toxicity was acceptable.

Adult↗

PubMedDate not supplied

Retroperitoneal infectious myositis.

A case of retroperitoneal infectious myositis is described. The symptoms of infectious myositis may be confused with those of other more frequent soft tissue pathologies (haematoma and sarcomata). This infection is more frequent in countries with a tropical climate. The most frequent aetiological agent is Staphylococcus aureus. This paper reports on the diagnostic and therapeutic problems of this disease as recently observed at the Division of Surgical Oncology of the National Cancer Institute in Genoa.

Adult↗

PubMedDate not supplied

Secretory carcinoma of the breast. Report of a case with fine needle aspiration biopsy.

A case of secretory carcinoma of the breast in a 48-year-old woman studied by fine needle aspiration (FNA) cytology is presented. The prominent intracytoplasmic vacuolization and numerous signet-ring forms and the presence of sheets of neoplastic cells with large intercellular spaces should permit its diagnosis in FNA specimens. The differential diagnosis of this rare lesion from other breast neoplasms that show similar features is discussed.

Biopsy, Needle↗

PubMedDate not supplied

[Changes in the self image of 2 groups of women after breast surgery].

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Adult↗

PubMedDate not supplied

[Arterial chemotherapy of tumors. Considerations on 159 cases].

The results obtained in 153 patients suffering from advanced primary, residual, recurrent and metastatic cancers localized mainly in the cervico-cephalic district and in other sites (skin, extremities and pelvis, liver, thoracic wall, breast) in whom locoregional intraarterial chemotherapy was employed from 1967, are reported. In order of frequency, the commonest antiblastics used were Methotrexate, 5 FU, Vincristin and DITC. Long-term results show an average remission of 52% and mean survival of 11.4 months; these values are liable to wild fluctuations in relation to various factors such as site, development, state of regional lymph nodes, and any previous surgical, radiation or antiblastic therapy. Intraarterial treatment is found to have the best effect in cases of cancer which have not previously been subjected to any therapy at all, and which involve the cervico-cephalic districts, the liver and melanomas.

Adolescent↗

PubMedDate not supplied

Non palpable breast lesions: preoperative sonographic localization.

From 1987 to 1992 at our Institute, 253 patients with non palpable breast lesions (NBPL) underwent a surgical excision. Fifty-one lesions (19.7%) were localized by an injection of a sterile 3% charcoal suspension under sonographic guide. The sonographic features of NBPL were classified as follows: positive in one case (2%), doubtful in 31 cases (60%) and negative in 19 cases (38%). According to our data the preoperative sonographic localization is a useful alternative procedure to stereotactis mammography in case of breast masses and/or areas of increased tissue density or distorted breast architecture.

Adult↗