178 cases of post-operative irradiation for breast cancer (145 T1, T2, T3 and 33 T4) are analyzed. According to the surgical procedure there are 146 cases of radical modified mastectomy (Patey) and 32 cases of radical mastectomy (Halsted). The axillary status reveals 50% of involved nodes, but radiotherapy has been systematic on chest wall and supra-clavicular, parasternal, axillary lymph nodes areas. Loco-regional failures are only situated on chest wall (3,9%) and in the supraclavicular area (1,7%). The five year actuarial rate of locoregional control is 93% and 98% if we exclude 7 locoregional failures contemporaneous or consecutive to a metastatic evolution. The five year actuarial rate of metastatic remission for patients with negative axillary nodes (N-) is 83% against 55% for N+ (p < 0,001). The five year actuarial survival rate is 92% (N-) and 64% (N+) (p < 0,001). We discuss about indications of selective irradiation of chest wall and parasternal area for patients with negative axillary nodes and also about post-operative immuno-suppression, and chronology of chemotherapy.

Adult↗

PubMedDate not supplied

[Bilateral lobular in situ carcinoma discovered by sub-cutaneous mastectomy (author's transl)].

The authors relate the observation of a 42 years old woman with antecedents of mastodynia from several years and numerous operations for fibroadenoma. During the follow-up a sub-cutaneous mastectomy is realized owing to the discovery of clustered calcifications on mammographic study, which reveals a bilateral lobular in situ carcinoma. They talk over surgical procedures in this form of carcinoma.

Adult↗

PubMedDate not supplied

[An usual observation of Bouveret syndrome (author's transl)].

An unusual observation of Bouveret syndrome is reported. It occurred in a male patient, under the usual age for this disorder, with no history of cholelithiasis. Diagnosis was only established during the surgical procedure. There were neither radio-opaque stones nor air in the common biliary duct. Attempts to opacify the fistula failed. Gastro-entero-anastomosis, which is sometimes proposed because of the patient's poor general condition, is often necessary because of the local lesions. This procedure allows to wait until the local condition improves before undertaking the complete cure during the second procedure, with considerably lesser risk.

Cholelithiasis↗