Breast-conserving therapy for macroscopically multiple cancers
| Autor: | Robert Amalric, Jocelyne Jacquemier, Henri Brandone, Claude Bressac, Jean-Maurice Spitalier, John M. Kurtz, Yves Ayme, Daniel Hans |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
medicine.medical_specialty
Time Factors medicine.medical_treatment Breast Neoplasms Gross examination Neoplasms Multiple Primary Actuarial Analysis medicine Methods Combined Modality Therapy Mammography Humans Multiple tumors Survival rate medicine.diagnostic_test Gross Pathologic Examination business.industry Local failure Middle Aged Surgery Radiation therapy Survival Rate Female Neoplasm Recurrence Local business Research Article |
| Zdroj: | Annals of surgery. 212(1) |
| ISSN: | 0003-4932 |
| Popis: | Of 586 unilateral stage I-II breast cancers treated with conservative surgery and radiotherapy, 61 patients were found to have two or more macroscopic tumor nodules, diagnosed either clinically (n = 20), mammographically (n = 2), or on gross pathologic examination (n = 39). After a median follow-up of 71 months, 15 of 61 (25%) of the patients with multiple tumors developed recurrence in the treated breast, compared to 56 of 525 (11%) of patients with single cancers (p less than 0.005). Local failure occurred in 6 of 37 (16%) of bifocal tumors and in 9 of 24 (35%) of patients with 3 or more tumor foci. Recurrence was more frequent for multiplicity diagnosed clinically or mammographically (8 of 22 patients, 36%) than when it was apparent only to the pathologist (7 of 39 patients, 18%). Only 1 of 21 bifocal tumors diagnosed on gross examination recurred. Local failure occurred in only 1 of 22 cases with clearly negative resection margins; the remaining recurrences were associated with positive (n = 3) or indeterminate margins (n = 11). In contrast with recurrences of unifocal breast cancers, local failures in these patients tended to be located at a distance from the original foci, to be multifocal, or to be diffuse, including skin involvement. Only four recurrences presented as a single focus in the vicinity of the original primary tumors. This study indicates that macroscopically multiple breast cancers are at higher local failure risk, especially if multiplicity is clinically apparent, or if three or more gross nodules are seen on pathologic examination. Negative resection margins appear to be essential for satisfactory results. |
| Databáze: | OpenAIRE |
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