Recurrence after lumpectomy for comedo-type intraductal carcinoma of the breast
Article Abstract:
Ductal carcinoma in situ (DCIS) is a form of breast cancer that is more commonly diagnosed now that evidence from mammography is available. In one recent study of diagnoses made primarily by mammography, DCIS comprised 22 percent of the breast cancer diagnoses. The recommended treatment for this condition is total mastectomy (removal of the breast, lymph nodes, and chest wall muscles), but studies are ongoing to evaluate less extensive surgical procedures. One type of DCIS, comedo type, may be a particularly aggressive form. A study was performed to evaluate the course and recurrence of comedo-type DCIS in 38 patients (average age, 54 years) treated with less than total mastectomy (lumpectomy). The average follow-up time was 39 months. Approximately one-third of these women had a first-degree relative with breast cancer. Thirty were treated with surgery and only four suffered a recurrence, one of which was invasive. Recurrences were ipsilateral; no one developed carcinoma in the other breast. Eight patients were treated with radiotherapy in addition to surgery; two developed recurrences, and one recurrence was invasive. A problem in evaluating recurrence of comedo-type DCIS is the paucity of patients who have not undergone mastectomy. Recurrence rates from other published studies are reported, as are findings of particular genetic abnormalities associated with the aggressiveness of comedo-type DCIS. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1990
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Reconstruction with free bowel autografts after pharyngoesophageal or laryngopharyngoesophageal resection
Article Abstract:
Reconstructive surgery after partial removal or resectioning of the larynx and/or pharynx with part of the esophagus (pharyngoesophageal or laryngopharyngoesophageal resection) for cancer is becoming increasingly popular because it may restore speech and swallowing functions to these patients. Serious complications still exist, but within the past 10 years a method using intestinal tissue taken from the same patient (free bowel autografts) has been identified as a promising new operation. This article contains the results of reconstructive surgery using bowel autografts in 26 males and 11 females (age range was 37 to 78 years with a majority between 50 and 69). The patients underwent abdominal surgery immediately after tumor resection. The procedure was lengthy (taking over 10 hours in 68 percent of the cases) but successful in 36 of 37 cases (97 percent). Only 28 patients were available for follow-up evaluation. Twenty-four patients had no speech capacity and four patients had limited ability. With respect to swallowing function, nine patients had no difficulty and 19 experienced some problems. In the near future, this surgical technique may become the leading method of reconstruction after pharyngoesophageal resection. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1989
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