Response of predominantly recalcitrant cutaneous warts to topical chemotherapy.
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Administration, Cutaneous↗
Biomedical subjects
J S Link
Publications and source records attributed to J S Link.
Gemcitabine plus cisplatin repeating doublet therapy in previously treated, relapsed breast cancer patients.
PURPOSE: To determine the safety and efficacy of gemcitabine plus cisplatin for patients with relapsed adenocarcinoma of the breast. PATIENTS AND METHODS: Previously treated patients with adenocarcinoma of the breast received cisplatin (30 mg/m(2)) plus gemcitabine (1,000 mg/m(2)) on days 1, 8, and 15 of each 28-day cycle, which was changed after patient no. 12 to cisplatin (30 mg/m(2)) plus gemcitabine (750 mg/m(2)) days 1 and 8 of each 21-day cycle. RESULTS: Of 30 patients, three (10%) had complete and 12 (40%) had partial responses, for an overall response rate of 50%. Two objective responses were observed among the four patients accrued after relapse that followed high-dose/stem-cell therapies. The median time to progression was 14 weeks. The median time to progression for objective responders was 23.5 weeks, with a range of 8 to 68 weeks. Toxicities included grades III and IV neutropenia in 13%, anemia in 6%, thrombocytopenia in 31%, grade III nausea in 4%, and grade II peripheral neuropathy in 2% of 151 treatment cycles. Moderate alopecia occurred in four patients. There were no treatment-related deaths. CONCLUSION: Cisplatin plus gemcitabine is active and tolerable for patients with relapsed breast cancer. Responses observed in previously treated patients, including high-dose/stem-cell failures, indicate activity in otherwise drug-refractory patients.
Adenocarcinoma↗
History and overview of comprehensive interdisciplinary breast centers.
The comprehensive interdisciplinary breast center represents a model for delivering breast care in an efficient and cost-effective manner. It is a better way of caring for women with breast disease and allows for an interdisciplinary treatment by various specialists working and communicating with each other. The center allows for incorporation of new programs and innovations of care. As breast cancer care undergoes further changes, the comprehensive breast center facilitates progress and serves as a model for other disease-specific interdisciplinary programs. The evolution of breast centers and types of models are reviewed, and key factors of success are outlined in this article.
Breast Neoplasms↗
A breast cancer care report card. An assessment of performance and a pursuit of value.
The transition to managed care raises concerns about the resulting quality of care. The report card, a publicly released, standardized report on quality, has received widespread acceptance as a method to evaluate physician performance. Current report cards provide insufficient information to allow purchasers of health care to assess accurately the performance of professionals who provide breast care. To overcome these limitations, we propose an expanded report card on breast cancer care. Mammographers and general surgeons would assess an independent series of at least 100 consecutive cases of newly diagnosed breast cancer. Mammographers would determine the percentage of invasive cancers < 15 mm detected on screening mammograms in asymptomatic women aged 50 to 74 years. Surgeons would determine the percentage of combined stages 0 and 1 breast cancers detected and the percentage of patients receiving breast-conserving surgical therapy. Performance targets are set at 60% for invasive cancers < 15 mm detected on screening mammography, 60% for combined stage 0 and 1 breast cancers, and 50% for patients receiving breast-conserving therapy.
Aged↗
Benign breast disease.
Benign breast disease is common with an estimate of over half the female population at sometime seeking medical attention for a breast problem. The clinician must prove that the woman with a breast problem (ie, tenderness, lump, discharge) does not have a malignancy. This is done using a history and physical examination and, when indicated, mammography, ultrasonography, ductography, fine needle aspiration biopsy, or excisional biopsy. A comprehensive breast center allows for an efficient and cost-effective workup for women with a breast problem. In this context, benign breast disease and preinvasive breast cancer is presented.
Algorithms↗
Improved mammographic accuracy.
Use of ancillary imaging studies to evaluate suspicious screening mammograms can improve their positive predictive value for detecting malignant lesions. In 1989 8181 screening mammograms were performed at the breast evaluation center at Memorial Hospital Medical Center in Long Beach. A total of 670 patients were called back for magnification views or ultrasonographic evaluation, and 92 of these patients underwent surgical biopsy. There were 42 cancers diagnosed, yielding an accuracy rate of 46%.
Biopsy, Needle↗
Changes in the patterns of patient work-up in community hospital oncology programs and in comparison hospitals.
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Breast Neoplasms↗
5-Flourouracil in hepatocellular carcinoma: report of twenty-one cases.
Twenty-one patients with biopsy-proven hepatocellular carcinoma were treated with oral or intravenous 5-Fluorouracil according to a randomized treatment schedule. Twenty-one patients were evaluable for response and toxicity. The two groups were comparable in distribution of pretreatment characteristics. There were no objective responses in either group. This is the largest reported group of patients with hepatocellular carcinoma treated with 5-Fluorouracil. Toxicity occurred in 46% of patients treated, but was tolerable. In contrast to previous reports, we have found that weekly 5-Fluorouracil given orally or intravenously is not of significant value in the treatment of hepatocellular carcinoma.
Administration, Oral↗