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At least 1,009 records · Page 56Linked to original sources
PubMed1985

Specimen xeroradiography after needle localization and biopsy of noncalcified, nonpalpable breast lesions.

Xeroradiography was used to detect and aid in needle localization of 63 nonpalpable breast lesions over an 8-year period. In 28 patients (44%), no microcalcifications were present in the lesion biopsied. Xeroradiographs of these noncalcified lesions after their submersion in water carried a clean and close resemblance to their in vivo appearance and aided the pathologist in localizing the abnormality within the biopsy specimen. This simple method improved the accuracy of the needle-guided biopsy while allowing excision of minimal breast tissue. A total of 17 (27%) lesions revealed malignancy. At the time of mastectomy, all carcinomas were at an early stage with no nodal involvement. No recurrence has been detected to date with a mean follow-up period of 24 months. This procedure requires close cooperation between the surgeon, radiologist, and pathologist.

Adult↗
PubMed1981

Detection of placental protein five (PP5) and pregnancy-specific glycoprotein (SP1) in benign and malignant breast disease.

Sensitive radioimmunoassays for the placental proteins PP5 and SP1 were used to investigate possible ectopic synthesis of these proteins by breast tumors. Elevated serum levels of the proteins were found in a small proportion of patients who had undergone mastectomy for malignant tumors, but little useful information on tumor spread could be gained from such measurements. In two patients with elevated pre-operative serum PP5, the levels fell to normal upon resection of the tumor, suggesting that PP5 may be a product of the tumor. PP5 and SP1 were found to be present in the majority of homogenates of malignant and benign breast lesions; the highest concentrations of SP1 were found in malignant tumors, whereas with PP5, especially high levels were found in cases of simple cystic disease.

Adenofibroma↗
PubMed1986

Cosmetic results of immediate breast reconstruction post-mastectomy: a follow-up study.

We reviewed 95 patients who underwent immediate breast reconstruction at the time of mastectomy at least one year after operation for assessment of cosmetic results and complications. There were 45 rectus abdominis and 38 latissimus dorsi myocutaneous flaps used for reconstruction. Twelve patients had subpectoral implants without a flap. The results show a remarkable concordance of assessment by patient and surgeon: both found simple subpectoral prosthesis insertion to be inferior to flap reconstruction. Flap reconstruction gave satisfactory results in the majority of patients; latissimus dorsi and rectus abdominis flaps gave similar cosmetic results. However rectus abdominis flaps showed a higher complication rate of flap necrosis and incisional hernia of the abdominal wound. Psychological assessment showed no differences between the three types of reconstruction. We conclude that immediate breast reconstruction can give excellent cosmetic results, and provides an acceptable and safe means of ameliorating the effects of mastectomy. The number of grossly unsatisfactory results decreased notably as the series progressed. Experience and meticulous attention to detail are necessary, since many patients are unwilling to have revisionary procedures if the initial result is unsatisfactory.

Breast↗
PubMed1994

[Patients acceptance of immediate breast reconstruction after subcutaneous mastectomy in breast disease].

Most profound emotional impact for the women with breast carcinoma is experienced as loss of femininity as a result of surgical mutilation. From this point of view, the recommendation for reconstructive surgery provide the amelioration to patient's anxiety. Two hundred women with breast carcinoma including huge nonepithelial malignant and/or benign tumors who adopted the breast reconstruction were treated during a 13-year period in 1982-1994 at NCCH. The breast reconstruction was mainly created by latissmus dorsi musculocutaneous (LDMC) flap in one sitting (modified mastectomy plus simultaneous reconstruction). Thirty patients treated with subcutaneous mastectomy (conserving the nipple-areolar complex) among them, were followed by deepithelialized LDMC flap without implant as the procedure of choice in early carcinoma located in lateral half at a distance of at least 4-5 cm from the areola and in huge benign tumors. Although one patient was dissatisfied with ischemia of LDMC flap, this approach was safe, simple, and possible to produce the patient's satisfaction. There was a positive effect on life style and on sexual, social or work relationships.

Adolescent↗
PubMed1989

[10 years results following augmentation-plasty].

In order to investigate late results in cases with mamma-augmentations, we have controlled cases which have been operated between 1970 and 1980. From a total number of 70 cases 34 have appeared for control. In spite of the problems of capsular contracture the interest for mamma-augmentation has rather increased during this period of time. We have mainly used 3 types of implants: 1. gelfilled silicon prosthesis, 2. inflatable prosthesis, 3. gelfilled prosthesis with polyurethan coating (Aeshly). In most of the inflatable prosthesis (5) spontaneous perforations occurred so that they had to be exchanged. In 41 cases a simple augmentation was performed. Out of these 16 have been controlled. In 4 cases an augmentation was combined with mastopexy. All of these appeared for control. 13 out of 17 cases of subcutaneous mastectomy with augmentation mammaplasty were controlled. In all cases of subcutaneous mastectomy the prosthesis were placed retropectoral. In 18 cases the prostheses were exchanged either because of leakage or when the prosthesis was injured during a capsulotomy. In 2 cases the prosthesis was removed, in 1 case because of problems with the skin and in another case because of repeated severe capsular contracture even after two capsulotomies. The classification of Baker was used to express the severity of capsular contracture. Prosthesis which was placed retropectorally showed significantly less problems with capsular contracture than prosthesis which was placed subglandular.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Cytologic evaluation of lumpectomy margins in patients with ductal carcinoma in situ: clinical outcome.

BACKGROUND: Breast conservation therapy is controversial for ductal carcinoma in situ (DCIS) due to recently reported high recurrence rates. We believe that cytologic evaluation of lumpectomy margins improves efficiency and leads to a lower recurrence rate following lumpectomy for DCIS. METHODS: A prospectively accrued database of 1255 breast cancer patients at the H. Lee Moffitt Cancer Center and Research Institute was found to have 218 patients with DCIS (17.4%). Of those 218 cases, 114 were treated with lumpectomy, axillary dissection, and radiation therapy; the remaining 104 patients were treated with mastectomy with or without reconstruction. Imprint cytology was used to evaluate all lumpectomy margins. Permanent sections and imprint cytology were reviewed by the same pathologist. RESULTS: All lumpectomy specimens (116 tumors in 114 patients) were evaluated. The median follow up was 57.5 months (range 2-110 months). One hundred and three patients with 104 tumors were selected on the basis of pure DCIS (with or without microinvasion), and treated with lumpectomy, axillary dissection and radiation therapy. Of the 104 tumors utilizing attempted breast conservation therapy, 7 (6.6%) required mastectomy. There were 6 recurrences (6.1%) with a median time for recurrence of 47.5 months (range 27-85 months); four recurrences were comedo and two were noncomedo at original diagnosis. CONCLUSIONS: The determination of lumpectomy margins in DCIS patients using imprint cytology leads to an overall recurrence rate of 6.1% with reduction in operative time, and re-excision rate. Significant recurrence rates were associated with microinvasion and multifocal tumors (28%) versus simple DCIS at 5 years. Breast conservation therapy and surgical margin determination with imprint cytology for DCIS is a cost-effective and reliable method of treatment for simple DCIS.

Adult↗
PubMed1996

Breast reconstruction with anatomical expanders and implants: our early experience.

Dissatisfied with the upper pole fullness produced by the Becker expander/mammary prosthesis, we started using 'anatomically' shaped expanders and implants, as described by Maxwell, for breast reconstruction. We reviewed the results of our first 24 breast reconstructions in 19 patients, who were deemed suitable for reconstruction with this technique between August 1994 and April 1995 (9 months). The most commonly used expander was 500 cc (range 400-700 cc) and an average of 2.73 inflations was required before replacing the expander with a definitive implant. The minimum follow-up was 6 months. Few complications were recorded and all patients were very happy with the final result. We found that the anatomically shaped expanders and implants produced better aesthetic reconstructions compared to dome shaped prostheses. Importantly, the procedure was technically simple and the results readily reproducible.

Adult↗
PubMed1973

An approach to the detection and management of early breast cancer.

The mortality rate for breast cancer has not changed for 40 years. The ultimate results using the various surgical techniques differ very little. Local tumour excision produces survival rates comparable with those for more radical operations. Ideal treatment should give optimal quality and quantity of survival with minimal trauma. Survival is mainly determined by the ability to live in symbiosis with the disease and in most cases clinically obvious tumours are already incurable. Clinical examination alone will not detect disease at a stage early enough for more effective treatment. Mammography and thermography can detect occult breast cancer and, in particular, thermography can be used for serial examinations in high-risk patients because the procedure is simple and without hazard.

Adenocarcinoma↗
PubMed1990

Prospective evaluation of the role of fine-needle aspiration biopsy in the diagnosis and management of patients with palpable solid breast lesions.

To evaluate the role of fine-needle aspiration biopsy (FNAB) in the diagnosis and management of patients with palpable, solid and suspicious breast lesions, a total of 107 FNABs were performed on 98 patients under the prospective FNAB protocol. Eight-four FNABs were positive for breast carcinomas; of these 84 positive FNABs, 80 underwent mastectomy without open biopsy or frozen section. Our data showed a sensitivity of 95 per cent and a specificity of 100 per cent for diagnosis of breast malignancies on these patients. We concluded that FNAB is a simple, reliable, and cost-effective diagnostic procedure for patients with palpable breast carcinomas.

Algorithms↗
PubMed1989

[Diagnostic and therapeutic concepts in breast neoplasms].

Therapeutic decisions in breast cancer are no longer as simple and straightforward as they were. Radical masectomy has long ceased to be a routine application to every patient. A number of patients are now candidates for conservative surgery combined with irradiation. Patients who still require total mastectomy with axillary clearance may wish to undergo immediate or delayed breast reconstruction. In our department most patients with breast tumors are first seen in the outpatient clinic, where diagnostic work-up is completed and the therapeutic concept is discussed. If necessary, consultation with the radiotherapist and the plastic surgeon is available. Our diagnostic and therapeutic concepts are summarized in Fig. 1 and Table 1.

Breast↗
PubMed1977

A new topographic approach to the spread of breast cancer: the grid method.

In a series of 181 patients with breast cancer treated by mastectomy with axillary lymph node dissection, the authors developed and used an improved topographic technique, which they call the "Grid Method", which maps out the extent of a given cance of the breast. Three types of tumor spread are defined: Type 1, limited (L)(31%); Type 2, multifocal (M)(13.2%); and Type 3, extensive (E)(55.8%). This topographic information allows a more accurate assessment of prognosis when used in conjunction with the morphologic findings. Moreover, the topographic "Grid" study is simple to perform and easy to assess. Of prime importance is the relationship between the topographic and mammographic findings.

Axilla↗
PubMed2004

Treatment and outcome of patients with chest wall recurrence after mastectomy and breast reconstruction.

BACKGROUND: Chest wall recurrence (CWR) in the setting of previous mastectomy and breast reconstruction can pose complex management dilemmas for clinicians. We examined the impact of breast reconstruction on the treatment and outcomes of patients who subsequently developed a CWR. METHODS: Between 1988 and 1998, 155 breast cancer patients with CWR after mastectomy were evaluated at our center. Of these patients, 27 had previously undergone breast reconstruction (immediate in 20; delayed in 7). Clinicopathologic features, treatment decisions, and outcomes were compared between the patients with and without previous breast reconstruction. Nonparametric statistics were used to analyse the data. RESULTS: There were no significant differences between the reconstruction and no-reconstruction groups in time to CWR, size of the CWR, number of nodules, ulceration, erythema, and association of CWR with nodal metastases. In patients with previous breast reconstruction, surgical resection of the CWR and repair of the resulting defect tended to be more complex and was more likely to require chest wall reconstruction by the plastic surgery team rather than simple excision or resection with primary closure (26% [7 of 27] versus 8% [10 of 128], P = 0.013). Risk of a second CWR, risk of distant metastases, median overall survival after CWR, and distant-metastasis-free survival after CWR did not differ significantly between patients with and without previous breast reconstruction. CONCLUSIONS: Breast reconstruction after mastectomy does not influence the clinical presentation or prognosis of women who subsequently develop a CWR. Collaboration with a plastic surgery team may be beneficial in the surgical management of these patients.

Adult↗
PubMed1994

[Improvement of clinical symptoms by UFT and TAM and a case of bone metastasis from breast carcinoma during pregnancy].

At age 35, the patient was diagnosed with left breast carcinoma (T4bN0M0, Stage IIIb) during her first pregnancy, and underwent mastectomy of the left breast and bilateral oophorectomy. Although CPA was administered as adjuvant chemotherapy after the operation, left pelvic pain developed about a year after the operation, and bone metastasis was detected from the imaging diagnosis. Then, the therapy was switched to UFT (600 mg/day) and tamoxifen (20 mg/day), which markedly relieved the pain along with bone scintiscan (NC) and simple X-P (NC). Five years have passed since the operation, and the progress is excellent. There is neither increase of pain nor adverse reactions to drugs. Furthermore, the patient received breast reconstruction operation at her strong insistence in the third year after operation, and has achieved a high quality of life (QOL).

Adult↗
PubMed1983

Postoperative axillary lymphoscintigraphy in the management of breast cancer.

Postoperative axillary lymphoscintigrams have been performed according to a technique of two-staged injection in 313 patients who had undergone a radical mastectomy with axillary dissection for breast cancer. Total absence of visualization of residual nodes suggests that dissection could be said to be complete in only 35.8% of the investigated patients, or because of metastatic disease causing blockage. The visualized residual nodes in patients represent a risk of developing nodal relapse, especially with positive pathological demonstration of axillary node invasion and without nodal irradiation. On the other hand, when the investigation showed the interruption of the lymphatic pathways of the arm, patients developed upper limb edemas more frequently. It is concluded that this simple and non traumatic technique is of value in order to assess the immediate postoperative axillary nodal status, and that it may influence the treatment of the patients.

Axilla↗