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Biomedical subjects

G Crile

Publications and source records attributed to G Crile.

At least 37 records · Page 2Linked to original sources
PubMed1981

The relationship of surgeons and pathologists.

Diagnosis of breast cancer starts in the office with the routine aspiration of every nodule. Aspiration biopsy divides patients who have nodules into two categories: (1) those with positive cytologic results who are admitted to the hospital and, when there is any doubt about the diagnosis, are further evaluated by open biopsy and frozen section, followed by definitive treatment, and (2) those who have negative cytologic results and, if the mass persists, are treated by excisional biopsy without being admitted to the hospital; if the biopsy shows malignancy, definitive treatment is given later. If all thyroid nodules were subjected to aspiration biopsy, 90% of thyroid operations could be avoided, and the subsequent growth of the nodules could be prevented by giving suppressive doses of thyroid. Largely as a result of this practice, the incidence of operations on the thyroid at the Cleveland Clinic has fallen from more than 300 a year to fewer than 30. It is time that surgeons in this country took a lesson from their European counterparts and began to do needle biopsies routinely on nodules of the thyroid and breast.

Breast Neoplasms↗
PubMed1980

Results of partial mastectomy in 173 patients followed for from five to ten years.

A series of 173 selected patients was treated by partial mastectomy. Eighteen per cent of these also had axillary dissection and another 18 per cent were irradiated. The survival rate at five years was 76 per cent. In the earlier patients, despite adverse selection in terms of age and associated disease, 44 per cent survived for ten years. Twenty per cent of these patients required some form of additional treatment for the control of local or regional disease, but mastectomy was required in only 7.5 per cent. In the others, the cosmetic results were good. Although there is an increased risk of local or regional reappearance of the cancer that may require secondary treatment, partial mastectomy is a satisfactory method of treatment for selected patients with carcinoma of the breast who wish to have some of the breast tissue preserved. These patients should be warned of the increased risk of having to have a second operation for local recurrence, but they can be assured that, in terms of survival, the results seem comparable with those reported after total mastectomy. It is possible that the use of excisional biopsy and axillary sampling followed by external and interstitial radiation with iridium seeds may further increase our ability to save the breast.

Breast Neoplasms↗
PubMed1978

Cystosarcoma phyllodes.

Recurrence and metastases of a cystosarcoma phyllodes are poorly correlated with the histologic type and treatment used. There is some evidence, however, that the prognosis is more favorable for small tumors and minimal cellular atypism. Local excision seems to be associated with a higher incidence of recurrence of the tumor. Metastases can develop later from what appears primarily a benign, as well as a malignant, type. Mastectomy as primary treatment was not always effective in preventing the local recurrence of the tumor. If the tumor recurred after mastectomy, it gave rise to fatal metastases. The recurrence of the tumor after local excision is secondary to microscopic foci retained after enucleation. If a local excision is done, it should include a wide margin of mammary tissue around the tumor. Wide local excision, for small, slow growing and clinically benign tumors can be used as a first operation, with wider re-excision and later mastectomy if the tumor recurs. Large and rapidly growing tumors that suggest malignant disease should be treated primarily by mastectomy.

Adolescent↗
PubMed1978

Struma lymphomatosa and carcinoma of the thyroid.

In patients with struma lymphomatosa treated by feeding thyroid, the indicence of lymphomas is low, and the prognosis of the patients is relatively good. The risk of thyroidectomy on all patients with uncomplicated struma lymphomatosa would greatly outweigh the benefits of preventing carcinoma. The association between struma lymphomatosa and carcinoma of thyroid does not appear to be causal. When patients are fed thyroid, there is little or no tendency for struma lymphomatosa to progress to clinically detectable carcinoma of the thyroid. The association of struma and papillary carcinoma comes from the observation of lymphocytic infiltration of the tissues surrounding papillary carcinomas of the thyroid, the result either of a lymphocytic reaction to the carcinoma or to radiation rather than that the carcinoma arose as a result of lymphocytic thyroiditis. Observation of 373 patients with struma lymphomatosa diagnosed by needle biopsy and treated by feeding thyroid failed to reveal a single instance of carconoma of the thyroid in 3,000 patient years of observation. In patients with uncomplicated struma lymphomatosa, the possibility of malignant tumor does not provide an indication either for open biopsy or for thyroidectomy.

Biopsy, Needle↗
PubMed1977

Injection of steroids in painful breasts.

Fibrositis of the breast results in unilateral localized pain and tenderness in one breast. In most cases it can be specifically and permanently relieved by injection of steroids.

Adult↗