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Biomedical subjects

H Brandone

Publications and source records attributed to H Brandone.

At least 37 records · Page 2Linked to original sources
PubMed1988

Results of wide excision for mammary recurrence after breast-conserving therapy.

Of 1,245 patients treated with breast-conserving surgery and radiotherapy for Stage I and II breast cancers, 118 required a secondary operation subsequently for apparently isolated recurrence in the treated breast. Fifty-two of these 118 patients were selected for salvage treatment with wide excision, with or without axillary dissection, instead of resorting to mastectomy. With a median follow-up of 6 years, the actuarial cancer-specific survival (Kaplan-Meier) after treatment of recurrence was 79% at 5 years and 64% at 10 years. The probability of local control in the treated breast was 79% at 5 years after conservative salvage surgery. Of 12 patients in whom second local or regional recurrences developed, ten could be treated by further surgery. We concluded from this experience that wedge excision represents an adequate alternative to mastectomy in the salvage treatment of isolated breast recurrences that are mobile, 2 cm or smaller in diameter, and without signs of rapid growth.

Axilla↗
PubMed1988

Mammary recurrences in women younger than forty.

The crude mammary recurrence rate was studied in 5-year age intervals for 1,382 Stage I and II breast cancer patients treated by conservative surgery and radiation therapy and followed for a median of 11 years. Patients younger than 40 had a significantly higher local recurrence rate (41/210, 19%) than did older patients (106/1172, 9%). The majority of excess recurrences in the younger patients occurred early, with recurrence rates between 5 and 10 years being equal for the 2 age groups. A comparison of the clinical characteristics of the patient groups yielded no obvious explanation for the higher local recurrence rate in the younger patients, and 15-year cancer-specific survival was identical. Within the younger age group, recurrence rate was independent of clinical tumor size, and was unaffected by adjuvant treatment. Young patients with positive axillary nodes or negative hormone receptors appear to be at particularly high risk for mammary failure. Despite this apparent correlation with biologic aggressiveness, the 41 patients with mammary recurrence experienced long-term survival from time of primary treatment which was not significantly worse than that of patients not having had local recurrence. For 37 patients with operable mammary recurrence, the 10-year survival from time of salvage surgery was 64%.

Adult↗
PubMed1988

Contralateral breast cancer and other second malignancies in patients treated by breast-conserving therapy with radiation.

Metachronous contralateral breast cancers and other second malignancies were evaluated in 2,850 patients treated between 1960 and 1981 primarily with radiotherapy (RT) either alone or following breast-conserving surgery. One hundred eighty-four contralateral cancers were observed in 22,491 patient-years of observation (818 per 10(5) patient-years), with a cumulative probability of 4.5% at 5, 7.9% at 10, and 11% at 15 and 20 years. Compared to patients with unilateral tumors, those destined to develop contralateral cancers were younger (mean age 51.9 vs 56.6) and more often gave a family history of breast cancer. Contralateral breast cancers were more frequent for more extensive tumors (T3 10% vs T1-26%; with inflammatory signs 10.6% without 6%), and in patients with ipsilateral local recurrence (with 9.1%, without 5.6%). Patients with contralateral cancers had a significantly less favorable survival experience (15-year actuarial survival after primary therapy 42%) than patients without contralateral cancer (15-year survival 65.5%). In early stage patients treated with conservative surgery and RT, contralateral cancer was not prognostically more favorable than ipsilateral breast recurrence. Among 72 other second malignancies (320 per 10(5) patient-years) were 2 soft tissue sarcomas in the irradiated area. This corresponds to an incidence of 21 cases per 10(5) patient-years for survivors beyond the fifth year. The possible influence of RT on contralateral cancers and other second malignancies is discussed.

Breast Neoplasms↗
PubMed1988

Results of salvage surgery for mammary recurrence following breast-conserving therapy.

A retrospective analysis was performed of 118 surgically treated mammary recurrences, occurring following primary conservative excision and radiation therapy for clinical Stages I and II breast cancer. Actuarial cancer-specific survival following salvage surgery was 72% at 5 years and 58% at 10 years. With a median followup of 7 years, further local-regional recurrences were observed in 20 of the 118 patients, many of whom could be treated by further surgery. Actuarial survival after recurrence was significantly influenced by initial clinical stage, as well as by the disease-free interval following primary therapy, but was similar for both premenopausal and postmenopausal patients and for patients treated by radical or breast-conserving salvage operations. For recurrences after the fifth year, actuarial survival following salvage surgery was 83% and 68% at 5 and 10 years, respectively. Survival for Stage I patients was favorable regardless of disease-free interval. It is concluded that recurrences in the breast following primary treatment with limited surgery and irradiation have a considerably more favorable prognosis than that of local failures after primary radical surgery. Suggestions for the management of these recurrences are presented.

Age Factors↗
PubMed1987

[Breast cancer: prognostic factors. Apropos of 1000 conservative treatments].

Prognosis was analyzed as a function of histologic grade, axillary gland spread and hormonal receptors in a consecutive series of 1000 patients with breast cancer (stages I and II) treated by conservative tumorectomy and axillary curettage, combined with radiotherapy, and followed up for between 3 and 12 years. The three factors analyzed are of major importance in that they constituted a veritable tumoral identity card. Grade I tumors, the absence of glandular spread and the presence of hormonal receptors are correlated with cancer of good prognosis, whereas grade III tumors, major axillary spread and absence of hormonal receptors are related to a poor prognosis. Their interactions are studied by comparing associations of good and poor prognostic factors, allowing determination of populations at low and high risk of therapeutic failure.

Adult↗
PubMed1984

Radiation therapy after breast-conserving surgery for Stage I and II mammary carcinoma. Results of the Marseille experience 1961 to 1976.

This report describes the results of a program of limited surgery, usually tumor excision, followed by curative radiation therapy in a series of 794 evaluable Stage I and II breast cancer patients treated prior to December, 1976. Clinical cure rates at 5, 10 and 15 years were 85%, 74% and 58% respectively. At 10 years, 86% of the apparently cured patients had the affected breast preserved, 79% of them with a good cosmetic result. In 10-year local/regional recurrence rate was 14%, but 84% of local failures were operable. Salvage surgery provided ultimate local control for 94% of the operable local failures, 61.5% of whom lived for at least 5 years after their secondary operations. It is concluded that a combination of primary tumor excision, limited axillary dissection and curative radiation therapy provides end results which are equivalent to those of primary radical mastectomy and affords the considerable advantage of successful breast preservation in a large majority of cases.

Breast Neoplasms↗
PubMed1982

Radiation therapy with or without primary limited surgery for operable breast cancer: a 20-year experience at the Marseilles Cancer Institute.

Since 1960 more than 3000 consecutive patients with operable infiltrating breast carcinoma were treated by radiation therapy with or without primary limited surgery, which usually consisted of local excision. For tumors smaller than or equal to 5 cm the ten-year crude survival rate is 77% for patients without palpable axillary nodes (T1-2N0) and 63% for patients having axillary adenopathy (T1-2N0). For operable tumors exceeding 5 cm of diameter (T3N0-1) the ten-year crude survival is 34%. Thirty-five percent of the patients alive free of disease at ten years required a secondary operation for presumed local or regional tumor persistence or recurrence, although no residual disease was found in 24% of the operative specimens. Local-regional recurrence had no adverse effect on ten-year survival. This conservative approach offers most women with operable breast cancer an excellent chance at breast preservation with the same chance for ten-year survival as with radical mastectomy.

Axilla↗