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Biomedical subjects

S A Feig

Publications and source records attributed to S A Feig.

At least 109 records · Page 6Linked to original sources
PubMed1988

Significance and staging of nonpalpable carcinomas of the breast.

Current staging protocols for carcinoma of the breast do not contain precise definitions for cancers detected as suspicious mammographic findings only. We have examined the distribution of malignant lesions and the frequency of metastasis to the axillary nodes and multicentricity in 1,059 women who have undergone 1,132 biopsies of the breast for nonpalpable lesions in order to determine if nonpalpable carcinomas should be categorized and staged separately from those detected in the traditional manner. Of these 1,132 biopsies, 29.1 per cent (330) were malignant, including 190 invasive ductal carcinomas, 13 invasive lobular carcinomas, 81 in situ ductal carcinomas, 25 microinvasive ductal carcinomas, 20 instances of lobular carcinoma in situ and one instance of malignant carcinoid. None of the women with noninvasive or microinvasive carcinomas had axillary metastasis; however, of 167 women with invasive ductal or lobular carcinoma who underwent axillary dissection, 32.9 per cent had at least one positive axillary node. In those women in whom the invasive carcinomas presented as clustered calcifications, the likelihood of axillary metastasis was the same as in the women who had nonpalpable masses. The significant frequency of axillary metastasis in women with clinically occult cancers challenges the use of the term "minimal" to describe any invasive cancer, regardless of size. Although noninvasive and microinvasive ductal cancers may continue to be considered as "minimal," invasive cancers, regardless of presentation, should be staged according to their measured size on the mammograms that detect them.

Adult↗
PubMed1988

B cell acute lymphoblastic leukemia (ALL) in donor cells following bone marrow transplantation for T cell ALL.

Leukemia recurred in a child with acute lymphoblastic leukemia after a bone marrow transplant. The pre-transplant leukemia was of T cell origin whereas the post-transplant relapse leukemia was of B cell origin. The recurrence was shown to be in donor cells by analysis of chromosomes and restriction fragment length polymorphisms. Although the mechanism of leukemia induction is uncertain, the possibilities of donor relapse due to EBV infection or chromosomal exchange were disproven. An alternative mechanism must account for leukemia induction in this patient.

B-Lymphocytes↗
PubMed1988

Bone marrow transplantation for poor prognosis neuroblastoma.

These studies suggest that intensive chemoradiotherapy (eg., VAMP-TBI), if given relatively soon after diagnosis and before development of progressive disease, improves long-term survival for patients with advanced neuroblastoma. Although this particular therapy is not useful for those who already have developed progressive disease, other intensive regimens may warrant testing in this latter group of patients. Our current study is testing aggressive induction chemotherapy, ex vivo purging of autologous marrow, and VAMP-TBI followed by BMT. Because of the increasing risk of progressive disease with time after diagnosis, we recommend beginning the BMT phase by 20 weeks after diagnosis. This should result in 85% of newly diagnosed patients entering the BMT phase without progressive disease; and, with fewer toxic deaths, 90% should survive the BMT phase. Thus, approximately 70% of patients could be disease-free survivors 8-9 months after diagnosis. Because a significant number of patients still develop progressive disease during induction or after BMT, efforts are being made to improve induction and pretransplant therapies and to identify prognostic factors. If modifications of the current regimens do not decrease the rate of progressive disease, it may be necessary to develop additional or different therapy for patients identified to be at high risk. Hopefully, new strategies will further increase the percentage of patients with tumor-free survival.

Bone Marrow Transplantation↗
PubMed1987

Delayed surgery and bone marrow transplantation for widespread neuroblastoma.

From 1983 to 1986, 21 patients with poor prognosis neuroblastoma were treated with bone marrow transplantation. This regimen included induction chemotherapy, delayed surgical resection, local irradiation, and intensive chemoradiotherapy followed by infusion of allogeneic or autologous marrow. This therapeutic approach resulted in a 57% long-term survival rate (follow-up: 14-48 months), which appears to be approximately three times superior to conventional chemotherapy in a comparable group of children. In addition, complete resection was possible in 11 of 17 patients operated on after induction therapy. Recurrence in the primary site after bone marrow transplantation occurred in only one of 18 evaluable patients. Thus, this approach almost always eradicates primary tumor in patients with neuroblastoma with advanced disease.

Adolescent↗
PubMed1987

Bone marrow transplantation in patients with leukaemia previously transfused with blood products from family members.

Transfusions are withheld, whenever possible, from patients with aplastic anaemia who are potential bone marrow transplant recipients because of the increased risk of graft failure associated with transfusions prior to transplantation. Family members are specifically excluded as blood product donors to reduce the likelihood of sensitizing the recipient to antigens shared by the blood and bone marrow donor. This policy of not using family members, particularly the HLA-matched bone marrow donor, to provide blood products prior to transplantation has been extended to leukaemia as well. To evaluate this policy we reviewed the outcome of bone marrow transplantation in 18 patients with leukaemia transfused prior to transplantation with platelets and/or leucocytes from related family members. In 15 cases in which the outcome could be evaluated, engraftment was rapid and graft failure did not occur. Transfusion of blood products from related family members to patients with leukaemia prior to transplantation does not appear, therefore, to increase the risk of graft rejection.

Blood Donors↗
PubMed1987

Clinically occult breast lesions: localization and significance.

From early 1974 through September 1985, 927 needle-guided breast biopsies were performed for clinically occult breast lesions. Two hundred and seventy (29%) of these lesions were malignant. This frequency of malignancy was comparable to a 20% frequency in biopsy samples obtained because of clinical (palpable) findings. Of 142 patients with nonpalpable invasive lesions who underwent axillary dissection, 42 (30%) had histologically confirmed axillary metastases. Although these invasive lesions may be clinically occult, they are not inconsequential and demand appropriate treatment. For those patients in this series undergoing mastectomy, the frequency of multicentric cancer in the same breast was 39%. The past 10 years have witnessed a trend in surgical management away from the standard radical or modified radical mastectomy toward limited surgery and radiation therapy for so-called early breast cancer. When planning treatment for these occult lesions, one must consider their biological potential to metastasize as well as their propensity for multicentricity.

Adult↗
PubMed1987

Neuroblastoma: the role of MR imaging.

Thirty-five MR examinations were performed in 17 children with neuroblastoma during the course of their diagnostic evaluation and treatment. Findings were confirmed by correlation with the results of other imaging techniques, biopsies, and surgical and autopsy findings. MR accurately detected the lesions and their extent in all patients. It correctly evaluated the possibility of resectability and showed metastases, response to treatment and development of complications. MR appears to be a reliable technique for the diagnosis, staging, and follow-up of children with neuroblastoma.

Abdominal Neoplasms↗
PubMed1987

Mammographic changes after reduction mammoplasty.

Mammograms obtained in 24 patients after reduction mammoplasty were reviewed retrospectively to define the mammographic findings seen after this procedure. Nine characteristics were found. The most frequent findings were skin thickening and retraction of the lower portion of the breast, transposition of breast parenchyma from a high to a low position, and a high nipple. The image characteristics were then correlated with the surgical type of mammoplasty performed, that is, dermal transposition of the nipple vs full-thickness nipple-areolar graft. All patients who had dermal transposition had complete or partial preservation of continuity between the subareolar ducts and the nipple. Patients who had nipple-areolar grafts showed either disruption of the subareolar ducts or very fatty breasts without visible ductal tissue. Reduction mammoplasty produces characteristic and predictable mammographic changes.

Adult↗