Search PubMed⌕ Search

Biomedical subjects

R Amalric

Publications and source records attributed to R Amalric.

At least 37 records · Page 2Linked to original sources
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

The second ten years: long-term risks of breast conservation in early breast cancer.

A retrospective cooperative study was undertaken to analyze the fate of 300 clinical Stage I and II breast cancer patients who were alive and apparently cured with both breasts preserved, 10 years following primary limited surgery with irradiation. All patients had been treated by tumor excision, with or without axillary dissection, followed by megavoltage radiation therapy. Follow-up ranged from 10.5 to 26 years, median 14.5 years. The overall actuarial survival (Kaplan-Meier) of the 300 "cured" patients was 86% at 15 years and 78% at 20 years, with 38.5% of deaths attributable to breast cancer. The actuarial probability of remaining free of metastatic disease was 91% at both 15 and 20 years, independent of age or clinical stage. Sixteen patients (5.3%) developed recurrent cancer in the treated breast beyond the tenth year, the actuarial probability of remaining free of breast recurrence being 94% and 90% at 15 and 20 years, respectively. Contralateral breast cancers developed during the second decade in 5 patients, with a cumulative risk of 6.5% at 20 years. Significant treatment-related problems appeared during the second decade in 5 patients, including one chest wall sarcoma; all of these patients had received at least 60 Gy to breast and regional nodal areas. A comparison of these results with those in the literature allowed the following conclusions to be drawn: (a) the risk of death, as well as breast cancer mortality during the second decade, are similar for both conservatively and radically treated patients with Stage I and II breast cancer; (b) the risk of contralateral breast cancer is not greater than that observed following primary radical surgery without radiation therapy; (c) ipsilateral breast "recurrences" continue to occur at about 1% per year during the second decade. Such late recurrences are highly operable and have a favorable prognosis; (d) late progression of treatment-related sequelae is uncommon. This analysis supports the continued use of breast-conserving surgery with radiation therapy in the treatment of Stage I and II breast cancer.

Breast Neoplasms↗
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↗
PubMed1986

[Magnetic resonance imaging in rheumatology].

The authors report their experience with magnetic resonance imaging in rheumatology, established on more than 250 examinations. The method seems interesting for the study of discal and somatic spine diseases, and especially for the evaluation of tumor extension, the diagnosis of herniated disc, the diagnosis of spondylodiscitis, the exploration of the cervico-occipital joint. As compared to tomodensitometry, this method presents at the same time advantages and drawbacks. Peripherally, magnetic resonance imaging is useful for the exploration of bony tumors and evaluation of their extension. It gives excellent images of the knees and the hips where it seems to improve the results of tomodensitometry and bony scintigraphy in the diagnosis of osteonecrosis. It is likely that advances will broaden the scope of the indications and capabilities of this method.

Arthritis, Rheumatoid↗
PubMed1984

Time course and prognosis of local recurrence following primary radiation therapy for early breast cancer.

The frequency, time course, and prognosis of local recurrence following primary radiation therapy in 152 patients with early breast cancer treated before 1967 were examined. Local recurrence occurred at a constant rate over the first 14 years after treatment. The crude 15-year local recurrence rate was 22%. Of the 30 patients who developed an isolated local recurrence and underwent definitive secondary surgery, the 10-year freedom from distant relapse rate was 50%. These results indicate that breast cancer patients treated by primary radiation therapy require long-term follow-up to detect curable local recurrences.

Breast Neoplasms↗
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↗
PubMed1983

Late breast recurrence after lumpectomy and irradiation.

For 276 patients with early breast cancer followed from 10-21 years after lumpectomy and radiotherapy, the recurrence rate in the treated breast was 15.6%, and 7.2% developed contralateral breast cancer. Only 63% of breast recurrences occurred within 5 years, and the remainder were "late failures," with 5 of the 43 recurrences observed after 10 years. The proportion of failures occurring late was greater for T1 than for T2 tumors (53% vs 25%). Twenty-six percent of early recurrences were inoperable, and an adverse impact of early recurrence on 10-year survival was clearly demonstrable. Late recurrences were all operable and did not appear to be associated with decreased survival. Only 16 of the 36 patients (44%) with operable breast recurrence ever developed metastatic disease, and 5 year survival following salvage therapy was 62%. Although the treated breast remains at continuous cancer risk even beyond 5 year, the prognosis of late recurrence appears quite similar to that of contralateral breast cancer. We do not consider the phenomenon of late recurrence to lend support to a policy of primary mastectomy, just as the existence of contralateral breast cancer does not justify routine "prophylactic" contralateral mastectomy.

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↗
PubMed1981

[The future of women with isolated abnormal infrared thermogram of the breast (author's transl)].

Abnormal infra-red thermograms of the breast are called "isolated" when they are not accompanied by other clinical or paraclinical abnormalities. They occur in asymptomatic women systematically examined or in women consulting for mammary symptoms other than palpable nodules. Their incidence is about 10-15%. They are usually considered as "false-positive" findings, but when these women are regularly followed up breast cancers are found to occur with a frequency ranging from 5% to 38%. "False-positive" thermograms therefore imply a high risk of breast cancer. Extremely prolonged clinical surveillance with periodical radiothermic tests and, if necessary, guided biopsies are required for early detection of small-size or even impalpable mammary carcinomas.

Breast Neoplasms↗
PubMed1981

[Assessment of activity in bone tumours by telethermography (author's transl)].

The assessment of activity in bone tumours after irradiation is somewhat uncertain. In most cases, the process of healing cannot be assessed. The authors propose the use of tele-thermography, which was used 14 patients. In 8 cases, amputation was performed when tele-thermography showed persistent activity. In all cases, secondary microscopic examination of the amputated limb showed remaining active tumour in spite of negative radiological appearances. In 6 cases, in which tele-thermography was negative, the limb was not amputated with no recurrence up to the present time. The follow up study has varied from 15 months to 5 years. The authors consider that this technique is of great value in the assessment of the activity of irradiated sarcomata.

Amputation, Surgical↗
PubMed1980

[Immune competence before and after curative radiotherapy in breast cancer (author's transl)].

The level of non-specific immune response was evaluated in 409 operable breast cancer patients by a battery of classical tests performed at least before and after treatment. We propose a synthetic classification of the various tests into 5 categories (from I 1 to I 5) of growing pejorative weight for a rapid and better understanding between the laboratory and the clinicians and also for overall comparison in time. With this type of evaluation the percentage of patients exhibiting depressed immune response was 14 per cent initially and rose to 39 per cent at the end of irradiation. Six months later, however, only 3 per cent of the patients had an immune assessment lower than the initial level. The pronounced immune depression observed by other authors concerned mainly patients having undergone post-operative irradiation after removal of the breast. The curative treatments used here in the hope of avoiding radical breast surgery was performed under much different ballistic, biological and psychological conditions which should be taken into account before condemning the dangers of this method.

Adult↗