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T Wobbes

Publications and source records attributed to T Wobbes.

At least 145 records · Page 8Linked to original sources
PubMed1987

Localization and excision of nonpalpable breast lesions. A surgical evaluation of three methods.

Three methods of excising nonpalpable breast lesions have been evaluated: (1) "blind" method, using mammographic coordinates; (2) preoperative localization with the Frank needle; and (3) Frank needle localization aided by a multiperforated compression plate. Successful removal at first attempt occurred in about 80% with any method. The size of the biopsy specimens did not differ significantly among the three groups and is most probably a function of the breast volume. The failure rate was seven (2.1%) of 332 biopsies. Since three of the six repeated biopsies yielded specimens with malignancy, the persistence of a radiographically suspicious lesion on follow-up mammogram of the operated-on breast is an urgent indication for reoperation.

Adult↗
PubMed1987

Malignant fibrous histiocytoma of the breast with axillary lymph node involvement.

This case history describes a 70-year-old female patient with a malignant fibrous histiocytoma (MFH) of the breast with secondary involvement of the skin and axillary lymph node metastases. We think that in the case of a MFH of the breast a radical or modified radical mastectomy should be pursued instead of a simple mastectomy.

Aged↗
PubMed1987

Healing of experimental colonic anastomoses: effect of antineoplastic agents.

The effect of a combination of antineoplastic agents (bleomycin (2 mg/kg/d), 5-fluorouracil (10 mg/kg/d) and cisdiamminedichloroplatinum (0.35 mg/kg/d)), given intravenously, on the healing of colonic anastomoses was investigated in rats. Ninety-six male Wistar rats were divided into four groups. A control group of rats underwent surgery only. The remaining rats were operated either 2 days before, 2 days after or during the 5-day chemotherapy course. In all groups rats were killed after 3, 7 and 21 days. Wound healing of the anastomosis was assessed by measuring the bursting pressures and hydroxyproline contents. Operating in the middle of the 5-day chemotherapy course had the greatest effect on anastomotic healing. This was most apparent on the seventh day postoperatively. When surgery was performed on the second day after the chemotherapy course there was an early delay in wound healing as measured by hydroxyproline content. Seven days postoperatively concentrations were in the same range as those in the control group. Chemotherapy commencing 2 days after surgery did not affect anastomotic healing as compared to the control group. Bursting pressure and hydroxyproline content at the end of the experiment were more or less comparable in all groups.

Animals↗
PubMed1987

Mammographic and histopathologic correlation of nonpalpable lesions of the breast and the reliability of frozen section diagnosis.

During a period of ten years, 118 (32.9 per cent) instances of carcinoma were found in 359 specimens taken at biopsy for nonpalpable mammographic lesions. In recent years, the positive predictive value has increased from 68 per cent due to the development of magnification mammography and the use of a mammographic grid. Correlating mammographic and histopathologic data, the rate of malignant disease was 12.7 per cent for instances of a circumscribed or nodular mass, 32.4 per cent for clustered microcalcifications as the only suspect finding, 28.6 per cent when a mass with microcalcifications was present and 66.7 per cent when a stellate-shaped mass was found. Of 188 instances of carcinoma, 40 were noninvasive: 32 instances of ductal carcinoma (27.1 per cent) and eight of lobular carcinoma in situ (6.8 per cent). The possibility of frozen section diagnosis was studied retrospectively by comparison with the paraffin section reports. A correct diagnosis, whether benign or malignant, was achieved in 68 per cent. No frozen section examination was done in 17.3 per cent and the diagnosis was deferred to results of paraffin section in 12.2 per cent. False-negative results were encountered in seven patients (1.9 per cent) and false-positive results in two (0.6 per cent). Both of these patients had florid sclerosing adenosis. Although frozen section diagnosis is feasible in nonpalpable lesions of the breast, it is recommended that this method not be used in instances of pure microcalcifications and tiny solid masses of 5 millimeters or less.

Adult↗
PubMed1987

The effect of familiality on clinical presentation and survival in mammary carcinoma.

In a series of 467 patients treated for mammary carcinoma 96 (20%) had a family history for this tumour. Sixty-eight (71%) had at least one first degree, 28 (29%) a second or third degree family member. Only the mean age of the second degree relative group differed significantly from that of the non-familial group. The size of the primary tumour at first presentation did not differ significantly in the familial and non-familial group, as the estimated survival. So patients with a family history for mammary carcinoma did not present themselves in an earlier stage of disease. Because of the higher risk of developing this type of tumour in female relatives we have to instruct this potential patient group more explicitly.

Adult↗
PubMed1987

The carcinoid of the intestine.

From 1956 to 1985, 38 patients with a carcinoid of the intestine were treated. Tumours originating from the duodenum, ileum and colon had the worst prognosis. Fourteen out of 15 patients showed lymph-node metastases, and eight liver secondaries. Metastatic spread was rare (9%) if the primary tumour was small or an incidental finding (appendix). Even with metastatic spread there may be a longer survival due to the slow growth pattern of carcinoid metastases, which often become manifest several years after resection of the primary tumour. Metachronous liver metastases should be considered for surgical resection. Three of the 38 patients suffered from a carcinoid syndrome.

Adolescent↗
PubMed1986

The effect of antineoplastic agents on the healing of small intestinal anastomoses in the rat.

The influence of an intravenous 5-day combined chemotherapy with bleomycin (2 mg/kg/d), 5-fluorouracil (10 mg/kg/d) and cis-diamminedichloroplatinum (0.35 mg/kg/d) on the healing of ileal anastomoses was investigated in rats. Ninety-six male Wistar rats were used, divided into four groups. The rats in the control group had surgery without administration of cytostatic agents. The other rats were operated either 2 days after, 2 days before, or during the 5-day chemotherapy course. In each group, rats were killed after 3, 7, and 21 days. Anastomotic healing was assessed by measurement of bursting pressures and hydroxyproline levels. Intestinal healing appeared to be impaired most if the operation was performed in the middle of the antineoplastic chemotherapy course. The effects were most pronounced on the seventh postoperative day. Surgery on the second day after the chemotherapy course led to a slight and early delay in wound healing as measured by the hydroxyproline content. Seven days postoperatively, concentrations had returned to preoperative values. Surgery 2 days before chemotherapy induced only minor differences with respect to the control group. In all groups, bursting pressure and hydroxyproline content at 21 days were similar. Thus, antineoplastic agents retard but do not prevent healing of intestinal anastomoses. The effects are most pronounced when surgery is performed during chemotherapy. If possible, surgery should be performed prior to chemotherapy. Increasing the time interval between surgery and chemotherapy may decrease the delay in intestinal woundhealing.

Animals↗
PubMed1986

Thyroid cancer mimicking thyroiditis.

Two patients with thyroid cancer, who presented with clinical and biochemical features of subacute thyroiditis, are reported, Confusion in diagnosis delayed therapy from 3 to 8 months. The relation between thyroiditis and thyroid cancer is discussed.

Adult↗
PubMed1986

Multicentricity in nonpalpable breast carcinoma and its implications for treatment.

During a 9 year period, 300 consecutive women underwent breast biopsies solely because of nonpalpable, mammographically suspicous findings. One hundred clinically occult breast carcinomas were found, 65 of which were invasive and 35 noninvasive. Eighty-three mastectomy specimens were evaluable for evidence of multifocal carcinoma in another quadrant of the breast or at a distance of 5 cm and residual cancer outside the excisional biopsy cavity. Multicentricity was present in 47 percent and residual tumor in 60 percent of the whole group. When only clinically occult invasive carcinomas were considered, other foci of invasive carcinoma were demonstrated in 26 percent of the patients and residual invasive cancer in 35 percent. The rate of bilaterality was 14 percent, occurring synchronously in 11 percent of the patients. Any therapeutic procedure for nonpalpable breast carcinoma, whether invasive or noninvasive ductal carcinoma, should be directed to the whole breast. Mammography of the contralateral side should be an integral part of the preoperative work-up of patients with palpable lesions ipsilaterally.

Adult↗
PubMed1986

[Breast carcinoma in elderly patients; clinical aspects and treatment].

The incidence of breast cancer increases with age. Results of initial staging of the disease are similar in groups of younger and older women. The relative survival rates of younger and older patients with primary or advanced breast cancer are about equal, although the number of patients suitable for initial standard surgery and for chemotherapy declines with increasing age. In this context it has to be considered that the incidence of hormone dependent tumors increases with age. Therefore aged women with primary or advanced breast cancer are more often likely to respond to (alternative primary) endocrine therapy than younger ones. Trials exploring the possibilities of limited primary surgery and/or primary or adjuvant endocrine therapy in elderly patients are in progress. Until the present, it is recommended to treat elderly patients with breast cancer according to the general rules for this disease with the proviso that the general condition of the patient allows for this. Finally, older patients in whom early breast cancer is easily detectable by mammography, might optimally benefit from breast cancer screening programs.

Aged↗
PubMed1986

[The treatment of carcinoma of colon and rectum in patients over 70].

In the period 1967-1981, 102 patients older than 70 years were treated for a colorectal carcinoma. The average delay was 6.5 months. Obstruction as initial symptom was seen in only 8% of the cases. The resection rate was 85%. The postoperative mortality rate was 6% for patients who underwent a resection. For all patients the postoperative mortality rate was 8%. Surgery for colorectal carcinoma in the elderly is well tolerated, and a resection should be pursued as long as the general condition permits.

Adenocarcinoma↗
PubMed1986

The significance of microcalcifications without palpable mass in the diagnosis of breast cancer.

Microcalcifications constitute an important part of nonpalpable breast lesions and may be the first sign of a breast carcinoma. Between 1975 and 1984, 150 consecutive patients with clusters of at least five microcalcifications without palpable findings as the only indication for biopsy were treated. One hundred seventy-three groups of microcalcifications were excised and 51 malignancies were detected (29.5%). Most of the malignant lesions were noninfiltrating (56%). Axillary or distant metastases occurred in 11% of the fully evaluable cases. This warrants the expectation that these patients have a very favorable prognosis. Breast biopsy for nonpalpable-clustered microcalcifications is a feasible and valuable procedure. Close cooperation is required between the surgeon, radiologist, and pathologist.

Adult↗
PubMed1985

Phantom breast sensations following mastectomy.

Eighty-nine patients were studied for the incidence and nature of phantom breast sensations (PBS) after a modified mastectomy. Twenty-nine (33%) reported experiencing pain or itching in the breast or the more vague sensation that the breast was still present. Phantom breast sensations appeared generally within the first 3 postoperative months. The duration varies from a few seconds to a few minutes. There were great individual differences in the frequency at which PBS appeared. Forty-one percent had the experience monthly or more often. All of the patients with a high frequency of PBS (12) belonged to the group of 13 women who suffered under these sensations. The occurrence of PBS was not related to left or right mastectomy, radiotherapy, adjuvant chemotherapy, having a sexual partner, or a history of lactation. At the time of operation, women who later developed PBS generally were younger, premenopausal, more often had children, and had a preoperative history of breast sensations. Before the modified mastectomy, these four factors could be used to indicate the probability at which the woman would develop PBS.

Adult↗