Biomedical subjects

M Blichert-Toft

Publications and source records attributed to M Blichert-Toft.

238 records · Page 14Linked to original sources

PubMedDate not supplied

Long-term observation of serum thyroglobulin after resection of nontoxic goiter and relation to ultrasonographically demonstrated relapse.

The object was to carry out a prospective study of the changes in serum thyroid hormones and thyroglobulin (Tg) following resection of nontoxic goiter and to investigate if there was a correlation to the pattern of relapse. A group of 39 consecutive patients, mainly with nodular, nontoxic goiter, were studied for 13 years following thyroidectomy. No thyroid hormone replacement therapy was given after surgery. The preoperative serum Tg level was elevated. After operation the mean serum Tg declined to a nadir of 43 micrograms/L at 1 year and subsequently increased to 90 micrograms/L at 10 years, with large individual differences. In 19 patients the serum Tg increased, in 1 it decreased, and in 19 no significant alteration was observed. Serum free thyroxine and triiodothyronine indices decreased following resection but achieved normal levels within 6 to 12 months. Serum thyroid-stimulating hormone increased after resection, with a peak level 1 month after surgery, but it returned to normal levels at 1 year and remained stable for the rest of the period. At 13 years after resection the thyroid volume was determined by ultrasonography in 30 of the patients. In 10 patients the thyroid volume was enlarged (>/= 28 ml). In this group a rise of average serum Tg after resection [DeltaTg(10-1 year)] of 133 micrograms/L was observed, compared to 26 micrograms/L in the 20 patients without sonographic relapse (volume < 28 ml). A positive correlation was demonstrated between serum DeltaTg(10-1 year) postsurgically and thyroid volume 13 years after surgery. However, an overlap was observed between the groups with and without ultrasonographic relapse, probably in part due to large differences in the Tg synthesis activity of different follicle cell clones. It is concluded that repeated serum Tg determinations may provide biochemical evidence of increased growth activity of thyroid remnants monitored after goiter resection.

Adult↗

PubMedDate not supplied

Needle puncture followed by pneumocystography of palpable breast cysts. A controlled clinical trial.

In a prospective analysis of 123 consecutive patients the current clinical and mammographic criteria of a cyst of the breast proved well-suited as a basis of selection for pneumocystography. Only about 12 per cent of the punctured lumps were solid, 9.8 per cent of them benign and 2.4 per cent malignant. The therapeutic effect was satisfactory, 94 per cent of the cysts not showing any recurrence after pneumocystography during a 6-month follow-up period with repeated palpation and mammography one and 6 months after the aspiration. The 6 per cent recurrences appeared within one month. The appearance of the aerogram was reliable in differentiating between a simple cyst and an intracystic lesion, whereas neither the tendency to recurrence nor the cytologic examination afforded a reliable basis of evaluation.

Adult↗

PubMedDate not supplied

The significance of the frequency and occurrence of breast cancer for treatment. Essential aspects of new Danish studies of the natural history of breast cancer.

The natural history of breast cancer (BC) has been evaluated by two entirely different types of consecutive and unselected materials: The general female population. Females with the breast cancer disease. The frequency of in situ carcinoma in the general female population is about 25 per cent. The growth pattern of the in situ carcinomas is predominantly microfocal contrary to findings in mammography selected surgical materials where tumor forming and/or diffuse types contribute to more than 30 per cent. Evidence is established of three different stages of the development of invasive breast carcinoma: The benign epithelial hyperplastic stage, the microfocal in situ carcinoma stage and the cancer stage. Among females with the BC-disease the residual breast glandular tissue in the contralateral breast develops a new primary invasive carcinoma in 33 per cent and furthermore in situ carcinoma in another 35 per cent. Death of disseminated metastases and axillary lymphnode metastases is significantly related to these new primaries. Residual breast glandular tissue left behind after total mastectomy contributes to new primary invasive carcinoma. Thus among clinical chest-wall recurrences not less than 20 per cent were primary invasive cancers. Our investigations have considerable impact on treatment: As concern microfocal in situ lesions they support a conservative attitude as regard treatment, providing the females are included in prospective follow-up studies including mammography. As concern the contralateral breast they support a more active attitude, but more studies are needed. Meanwhile a close follow-up program is an inevitable consequence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Breast-conserving therapy vs mastectomy in early-stage breast cancer: a meta-analysis of 10-year survival.

BACKGROUND: The randomized trials comparing breast-conserving therapy (BCT), i.e., surgery and radiation to the breast, with mastectomy in early-stage breast cancer use a variety of protocols. Meta-analysis may assist in understanding the impact of these differences on survival. PURPOSE: To evaluate the possible variations of the relative efficacy of BCT and mastectomy in terms of overall survival according to tumor size, nodal status, and use of adjuvant radiation therapy. METHODS: The most recent published results and, where available, updated patient-level data from randomized controlled trials of BCT and mastectomy for early-stage breast cancer were combined in a meta-analysis using a random effects model. Pooled survival rates and odds ratios were generated according to subgroups of nodal status and tumor size. Five- and 10-year odds ratios were also determined according to adjuvant radiation protocol. RESULTS: The pooled odds ratio comparing 10-year survival for BCT and mastectomy was 0.91. The odds ratios comparing the two treatment regimens were not significant after grouping according to tumor size and nodal status. When more than 50% of node-positive patients in both the mastectomy and BCT arms received adjuvant radiation, both arms had similar survival rates. When less than 50% of node-positive patients in both arms received adjuvant nodal radiation, the odds ratio was 0.69, and patients receiving BCT had a survival advantage. CONCLUSIONS: Patients allocated to BCT have survival rates at least as high as patients allocated to mastectomy. When all protocols were combined, nodal status and tumor size did not significantly alter the relative survival rates. However, under some conditions, particularly for node-positive patients, BCT may confer a relative survival advantage over mastectomy. In particular, mastectomy without adjuvant radiation appears to be inferior to BCT for node-positive patients.

Breast Neoplasms↗