Search PubMed⌕ Search

Biomedical subjects

J Cantin

Publications and source records attributed to J Cantin.

At least 19 recordsLinked to original sources
PubMed2001

Clinical practice guidelines for the care and treatment of breast cancer: 13. Sentinel lymph node biopsy.

OBJECTIVE: To provide information and recommendations to women with breast cancer and their physicians regarding what is now known about sentinel lymph node (SLN) biopsy. OPTIONS: Axillary dissection; SLN biopsy followed by backup axillary dissection; SLN biopsy. OUTCOMES: Accurate determination of cancer stage, resulting in better-informed therapeutic decisions. EVIDENCE: Systematic review of English-language literature published from January 1991 to December 2000 retrieved primarily from MEDLINE and CANCERLIT. RECOMMENDATIONS: Axillary dissection is the standard of care for the surgical staging of operable breast cancer. If a patient requests or is offered SLN biopsy, the benefits and risks as well as what is and is not known about the procedure should be outlined. Patients should be informed of the number of SLN biopsies performed by the surgeon and the surgeon's success rate with the procedure, as determined by the identification of the SLN and the false-negative rate (the presence of tumour cells in the axillary nodes when the SLN biopsy result is negative). Before surgeons replace axillary dissection by SLN biopsy as the staging procedure at their institution, they should (a) familiarize themselves with the literature on the topic and the techniques needed to perform the procedure, (b) follow a defined protocol for all 3 aspects of the procedure (nuclear medicine, surgery, pathology) and (c) perform backup axillary dissection until an acceptable success rate (as determined by the identification of the SLN and the false-negative rate) is achieved. A surgeon who performs breast cancer surgery infrequently should not perform SLN biopsy. A positive SLN biopsy result or failure to identify an SLN should prompt full axillary dissection. SLN biopsy is contraindicated in women who have clinically palpable nodes, locally advanced breast cancer, multifocal tumours, previous breast surgery or previous irradiation of the breast. Staining of tissue sections with hematoxylin and eosin, and not immunohistochemical analysis for cytokeratin, should determine adjuvant therapy. Participation in randomized clinical trials is encouraged. [A patient version of these guidelines appears in Appendix 1.] VALIDATION: Internal validation within the Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer; no external validation.

Axilla↗
PubMed2001

Prevalence of founder BRCA1 and BRCA2 mutations in unselected French Canadian women with breast cancer.

The frequency of BRCA1 and BRCA2 mutations in women with breast cancer varies according to the age at diagnosis, family history of cancer, and ethnicity/country of origin. We set out to estimate the frequency of seven previously described founder mutations in BRCA1 and BRCA2 in all eligible French Canadian women diagnosed with invasive breast cancer at one Montreal hospital over a 20-month period. One hundred and ninety-two patients were eligible and 127 (66.2%) provided blood for genetic testing. We identified 4 women who carried a founder mutation (3.1%, 95% confidence interval 0.9-7.9%) in this population. Interestingly, all the mutations were in BRCA2. The mean age at diagnosis for mutation carriers was 51.2 years (range 49.1-53.5). Two of these 4 cases were lobular invasive carcinomas and 2 were ductal carcinomas, histological grade 1 or 2. Despite a small tumor size (< or =20 mm), axillary nodal involvement was present in 3 women. Estrogen receptors were strongly expressed in all cases. Two of the 4 cases reported a strong family history of breast cancer, but a family history of site-specific breast cancer was a relatively poor indicator of the presence of BRCA2 mutations. The absence of BRCA1 mutations may be a result of chance, but may also reflect different geographical origins of the most common BRCA1 mutations within the French Canadian population.

Adult↗
PubMed1998

Metastatic axillary lymph node technetium-99m-MIBI imaging in primary breast cancer.

UNLABELLED: Technetium-99m-MIBI scintimammography has been shown to be useful in the detection of primary breast cancer. The purpose of this study was to evaluate the potential role of scintimammography in detecting axillary lymph node involvement in patients undergoing scintimammography to detect primary breast cancer. METHODS: A group of 100 women with breast cancer who were scheduled for a Level I-II axillary dissection were prospectively studied. Scintimammography was performed in all patients before histopathologic confirmation of breast cancer. Two lateral (prone imaging) views and one anterior (supine) planar thoracic view were obtained 10-15 min after the injection of 25-30 mCi 99mTc-MIBI (10 min/view) by using a special breast positioning device (foam cushion) placed over the imaging table. Both of the axilla were included in the field-of-view. Two experienced blinded observers reviewed all cases both from films and from the computer screen with contrast adjustment when needed. The site of intravenous injection of 99mTc-MIBI was known to the interpreters in order to avoid reading any false-positive uptake in the axilla ipsilateral to the injection site. RESULTS: A total of 52 patients had no axillary lymph node involvement (611 negative nodes) while 48 patients had at least one axillary lymph node with metastatic involvement (180/502 positive nodes). The sensitivity of scintimammography in detecting metastatic axillary lymph node involvement was 79.2% (38/48), and the specificity was 84.6% (44/52). The positive and the negative predictive values were 82.6% (38/46) and 81.5% (44/54), respectively. CONCLUSION: This study shows that scintimammography has good diagnostic accuracy for detecting axillary lymph node involvement in patients with breast cancer. This information should be added to the result of standard scintimammography, which requires very minor modifications in order to simultaneously evaluate both of the axilla.

Axilla↗
PubMed1984

Intra-arterial infusion chemotherapy in rectal cancer.

Chemotherapy by intra-arterial infusion, using mitomycin C and 5-fluorouracil, was administered to six patients with cancer of the rectum. In three patients who presented initially with an inoperable rectal tumour, medication was infused through the inferior mesenteric artery. Tumour regression was documented in all three, allowing subsequent resection in two. Of three other patients with locally recurrent rectal cancer, none showed tumour regression after infusion, but two experienced substantial relief of perineal pain, with improvement in the quality of life. Unexpected complications occurred in the form of a reversible ischemic colitis in two patients and an arterioenteric fistula in a third.

Aged↗
PubMed1978

Calcium infusion and pentagastrin injection in diagnosis of medullary thyroid carcinoma.

Calcium infusion and pentagastrin injection were compared as tests to stimulate calcitonin secretion for the detection of medullary carcinoma of the thyroid. Plasma concentrations of immunoreactive calcitonin were measured by radioimmunoassay before and during both stimulation tests in 2 persons who had been found at operation to have medullary thyroid carcinoma, 1 relative in whom a cervical lymph node biopsy had shown medullary thyroid carcinoma and 36 asymptomatic relatives. The tests were carried out on separate days by intravenous infusion of calcium gluconate for 2 hours, to provide 3.75 mg/kg of elemental calcium per hour, and rapid intravenous injection of 0.5 microgram/kg of pentagastrin. Before stimulation immunoreactive calcitonin was undetectable in the plasma of 34 of the 36 asymptomatic persons; the 2 with elevated baseline concentrations of the hormone had a positive response to both tests. Seven others showed an increase in plasma immunoreactive calcitonin concentration only after pentagastrin injection. The two persons with initially elevated values and three of the seven with increased values after pentagastrin injection were found at subsequent operation to have focal medullary carcinoma and parafollicular cell hyperplasia; after the operation immunoreactive calcitonin was undetectable in the plasma, even after stimulation. Rapid injection of pentagastrin is more reliable than slow infusion of calcium as a stimulation test for the early detection of medullary thyroid carcinoma.

Adolescent↗
PubMed1978

Radiation-induced soft-tissue and bone sarcoma.

From the records of Memorial Hospital of the past 50 years, 47 cases with an established diagnosis of radiation-induced sarcoma were identified and divided into two groups: the first included 20 cases of soft-tissue sarcoma arising from irradiated tissues, and the second comprised 27 cases of bone sarcoma arising from normal bones in the irradiated field. Medians for the latent periods from irradiation to diagnosis of bone and soft-tissue sarcoma were 11 and 12, years, respectively. In bone sarcomas, the latent period was longer after larger radiation doses and children appeared to be more susceptible to cancer induction than adults. Criteria for establishing the diagnosis of radiation-induced sarcoma and the magnitude of the risk of bone sarcoma are discussed.

Adolescent↗
PubMed1976

Primary carcinoma of the gallbladder: study of 108 cases.

From 1948 through 1970, 108 causes of primary carcinoma of the gallbladder were recorded out of a total of 17 698 cases of cancer exclusive of skin cancer (incidence, 0.6%). This review indicated that the following are the chief features of this condition: Primary gallbladder carcinoma is mainly a disease of women older than 60 years; abdominal pain occurs in most patients and jaundice in more than half, and weight loss is also common; laboratory and radiographic features are nonspecific; the diagnosis is made or strongly suspected in only one-quarter and, moreover, in many patients the disease may not be discovered until pathologic examination is conducted postoperatively. Resection was possible in 41 of the 93 patients who underwent operation but treatment was conservative because it was palliative in 20, and in 20 of the other underwent cholecystectomy the disease was not recognized at operation. Overall, the 5-year survival rate was 6.4%; for those who underwent curative resection it was 33%; and for patients without visible metastases at operation the mean survival was 3 years. Improvement in survival will come from more frequent recognition of the cancer at operation so that an operation so that an operation more adequate than cholecystectomy may be performed; that is, cholecystectomy, wedge resection of liver and resection of regional lymph nodes.

Adenocarcinoma↗
PubMed1971

[Mammography].

Explore the source record for details and available documents.

Adult↗