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Biomedical subjects

J R Garbay

Publications and source records attributed to J R Garbay.

22 records · Page 2Linked to original sources
PubMed1992

[Esthetic results of breast reconstruction after amputation for cancer. 323 cases].

323 reconstructions of the breast were carried out at the Gustave-Roussy Institute and were analysed in order to assess the aesthetic results and the sequelae of these reconstruction operations. The majority of the patients were operated on between 1984 and 1989 with a median follow-up of 3.5 years (1 to 9 years). Three types of reconstruction were carried out: simple prosthesis behind the muscle (P, 69% of this population), latissimus dorsi flap (G.D., 11%), or transverse rectus abdominis flap (TRAM, 20%). These reconstructions were either carried out immediately (RMI, 23.5%) or later (RMD, 76.5%). The unanimous enthusiasm of the patients for reconstruction was the greatest encouragement for us to continue in this way. From the aesthetic point of view the transverse rectus abdominis flap (TRAM) proved to be superior to the others. Scar and functional sequelae of the latissimus dorsi flap (GD) were by no means nil in this series (table 9) in contrast with other studies that have been carried out. All the same the majority of these sequelae were larger scars. The functional poor sequelae were minor. TRAM sequelae were less frequent and usually mainly in the abdominal wall. A more accurate technique should lower the incidence. As far as the timing of surgery is concerned, immediate reconstruction did not alter the quality of results which were better (but not significantly statistically). This has already been published. On the other hand patients were more satisfied with RMD (p less than 10(-4)). The analysis of this unexpected result show the great significance of psychological factors in interpreting these results.(ABSTRACT TRUNCATED AT 250 WORDS)

Academies and Institutes↗
PubMed1990

[Cloacogenic cancers of the anal canal: a retrospective study of 17 cases].

This study involved 17 cloacogenic cancers classified on the Morson and Jass histological scale and on the TNM clinical classification as T1 (4), T2 (3), T3 (3) and T4 (7) and including 5 N+ cases at the time of diagnosis. Treatment combined radiotherapy and surgery and the overall actuarial survival was 45% after 5 years. These results confirm that the response to treatment of cloacogenic cancers is similar to that of epidermoid cancers, notably with regard to the response to radiotherapy, and that the prognosis depends above all on the initial extent of the cancer. In contrast, cancers showing little or no differentiation (small cell cloacogenic cancers) are distinguished from other duct cancers by their explosive metastatic potential.

Adult↗
PubMedDate not supplied

[Role of conservative treatment of ductal carcinoma in situ of the breast].

In 1994, the treatment of ductal carcinoma in situ of the breast remains a controversial subject. There are two reasons for this: first, there are many possible treatments and secondly, there is still much discussion on choice criteria. Possible options are: Total mastectomy which or without axillary dissection. Tumorectomy followed by locoregional radiation therapy. Simple tumorectomy. Tamoxifen can be added to each of these options. The choice criteria are based on our knowledge of the complex natural history of these cancers. In this area some of the current concepts must be seriously revised. All of the former concepts were based on lesions observed at the time of their elaboration. These were voluminous tumours, diagnosed late with no prior conservative treatment. However, today, the lesions observed are quite different. We see "young" lesions which are naturally much smaller. It would appear that the natural history of small sized in situ ductal carcinoma of the breast is quite different from that of large sized tumours. The lesions seen today are less multifocal and less multicentric in nature than is generally thought. The progression of a small tumour is essentially segmentary. Likewise, the risk of occult micro-invasion is certainly less than previously thought. Even if the risk of micro-invasion still does exist, the risk of axillary lymph node invasion (resulting from an unknown infiltrating zone of tumoural tissue) is much lower. Finally the dogma of radioresistance, which was not based on any carefully conducted radiobiological study, has lost its substance since recent results on radiosurgery combinations have been published.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗