1/95. Nail changes secondary to docetaxel (Taxotere).Docetaxel is a new taxoid antineoplastic drug widely used for advanced breast cancer. skin and nail toxicity are one of the more frequent nonhematologic adverse reactions. Besides dark pigmentations and Beau's lines, subungual hemorrhage, orange discoloration, acute painful paronychia, onycholysis, subungual hyperkeratosis and transverse loss of the nail plate are described. The type of nail alteration is related with the number of cycles administered and there are no efficacious preventive measures to avoid its development. Clinicians should recognize the clinical picture of these adverse nail reactions because docetaxel is used for several neoplastic disorders.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
2/95. fatigue in women receiving adjuvant chemotherapy for breast cancer: characteristics, course, and correlates.This study investigated the characteristics, course, and correlates of fatigue in women receiving adjuvant chemotherapy for breast cancer. Fifty-four patients were assessed before the start of chemotherapy and during the first three treatment cycles. An age-matched sample of women with no cancer history was assessed at similar time intervals for comparison purposes. Results indicated that breast cancer patients experienced worse fatigue than women with no cancer history. These differences were evident before and after patients started chemotherapy. In addition, fatigue worsened among patients after treatment started. More severe fatigue before treatment was associated with poorer performance status and the presence of fatigue-related symptoms (e.g., sleep problems and muscle weakness). Increases in fatigue after chemotherapy started were associated with continued fatigue-related symptoms and the development of chemotherapy side effects (e.g., nausea and mouth sores). These findings demonstrate the clinical significance of fatigue in breast cancer patients before and during adjuvant chemotherapy treatment. Results also suggest that aggressive management of common side effects, such as nausea and pain, may be useful in relieving chemotherapy-related fatigue.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
3/95. Recurrent inflammation in a site of previous necrotising fasciitis during intravenous CMF chemotherapy.We present the case history of a patient with breast carcinoma who developed repeated inflammation at the site of previous necrotising fasciitis following each cycle of intravenous CMF chemotherapy. This complication has not previously been reported.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
4/95. Bilateral facial nerve palsy secondary to the administration of high-dose paclitaxel.Bilateral facial nerve palsy is an uncommon occurrence. We describe a case of bilateral facial nerve palsy secondary to a single cycle of high-dose paclitaxel therapy (825 mg/m2), in a woman with breast cancer. Prior to her high-dose therapy, she had a residual grade 2 peripheral neuropathy following treatment with ten cycles of standard-dose paclitaxel (total dose 3200 mg). The features of the peripheral neuropathy due to standard-dose paclitaxel, which can be both motor and sensory, are well described. Cumulative paclitaxel dose is considered a risk factor for development of the neuropathy. Although facial nerve palsy secondary to paclitaxel is not previously reported, other cranial nerve toxicity has been described. Consistent with reports of the reversibility of paclitaxel-induced peripheral neuropathy, the facial nerve palsies in our patient resolved over 23 months. Ongoing studies of high-dose paclitaxel warrant close attention to its cumulative neurotoxic effects, particularly in patients previously treated with neurotoxic chemotherapy.- - - - - - - - - - ranking = 2keywords = cycle (Clic here for more details about this article) |
5/95. Clinical assessment of a breast mass: a case study.The estimated 180,300 new cases of breast cancer that were diagnosed in the united states during 1998 represent only a small percentage of the breast masses discovered by women and their healthcare providers during the same year. Almost half of women who have regular menstrual cycles will experience a breast mass during their reproductive years; and from 50% to 90% of all women will encounter fibrocystic breast changes. Imaging (ultrasound and mammography) and manual palpation have been demonstrated to be the most useful methods of breast mass detection and evaluation. A woman's age and reproductive status are factors to be considered in the selection of a protocol for the clinical assessment of a breast mass. While a suspicious lesion warrants immediate physician referral, nurse practitioners have important roles to play in the identification, documentation, and appropriate follow-up of breast masses.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
6/95. Primary neuroendocrine small cell carcinoma of the breast.A 60-year-old Turkish woman presented with a left breast mass, which was considered for neoadjuvant chemotherapy. By the end of the treatment cycles, the tumor had decreased in size, and the patient underwent modified radical mastectomy with axillary lymph node dissection. Pathologic examination of the tumor revealed a small cell carcinoma with neuroendocrine features confirmed by immunohistochemical stains. Multiple axillary lymph nodes were involved by metastatic small cell carcinoma carrying the same morphologic characteristics noted in the primary breast tumor. We hereby present this case as a primary neuroendocrine small cell carcinoma of the breast. This entity occurs very rarely in the breast, and fewer than a dozen cases have been reported in the literature. Extrapulmonary small cell carcinoma of the breast is reportedly a very aggressive tumor for which no consensus for treatment has yet been drawn.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
7/95. Recall phenomenon following epirubicin.The case history is presented of a 46-year-old lady who was treated postoperatively for breast cancer with combination chemotherapy containing the antitumour agent epirubicin. The second cycle was complicated by a mild extravasation injury in the antecubital fossa, which settled with conservative management. Two weeks after a subsequent infusion into a different extremity she developed inflammation at the original site of injury, which rapidly led to tissue breakdown requiring surgical debridement and microvascular free flap reconstruction. To our knowledge, epirubicin has never been previously associated with 'recall reactions'. Histological evaluation of the debrided tissue has revealed a possible underlying mechanism for the cell damage.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
8/95. Synchronous primary cancers of the breast and cervix: planning multidisciplinary primary treatment [clinico-pathological conference]Multiple metachronous primary malignancies are becoming increasingly frequent; however, multiple synchronous primary malignancies are still unusual. We report the case of a 61-year-old woman with synchronous stage IIIB ductal carcinoma of the left breast and FIGO stage IB2 squamous cell carcinoma of the cervix. The patient was treated initially every 4 weeks with a 24-h intravenous infusion of paclitaxel (175 mg/m2) followed by a 1-h infusion of carboplatin (area under the curve of 5 mg/ml x min) with concurrent irradiation of the pelvis. Significant toxic reactions including nausea, vomiting, and diarrhea required hospitalization or outpatient intravenous fluids and antiemetics. After four cycles of chemotherapy, the breast cancer was in complete clinical remission, and the patient underwent a modified radical mastectomy with axillary lymph node dissection. Pathologic findings revealed a few microscopic foci of residual infiltrating ductal carcinoma exhibiting a marked treatment effect; none of the 14 axillary lymph nodes removed showed evidence of metastatic tumor. A near-complete pathologic response of the breast cancer and a complete clinical response of the cervical cancer were obtained. Adjuvant chemotherapy for the breast cancer was then initiated, followed by radiation and hormonal therapy.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
9/95. Cutaneous fibrosis induced by docetaxel: a case report.BACKGROUND: Docetaxel is a taxoid antineoplastic agent approved for use in the treatment of metastatic breast carcinoma. The current study reports an unusual case of generalized cutaneous fibrosis in a 39-year-old white female after treatment with 18 cycles of docetaxel for metastatic breast carcinoma. methods: Cutaneous fibrosis represents a rare and unique reaction associated with the cyclic use of docetaxel. The reaction is manifested by a distinct sequence of events involving pronounced edema followed by the rapid development of cutaneous fibrosis in dependent areas. RESULTS: Cessation of therapy results in dramatic reversal of the fibrotic process. CONCLUSIONS: This case report further substantiates the belief that docetaxel represents one of a very limited number of agents that appear capable of giving rise to scleroderma-like features.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
10/95. Three cases of malignant lymphoma of the breast.We report three cases of malignant lymphoma (ML) of the breast and discuss diagnosis and management. The first case is a 35-year-old woman who had a left breast tumor. Fine needle aspiration cytology (FNAC) showed ML. mastectomy was performed without any adjuvant chemotherapy. histology revealed diffuse large B-cell lymphoma of REAL classification. Seventy one months after surgery, lesions indicating relapse were detected in nodes of the right axilla, mediastinum and para-aorta.She underwent eight cycles of CHOP regimen, but 1 month after the chemotherapy a brain metastasis was detected. The patient then received a high-dose methotrexate regimen with whole-skull irradiation. The second case is a 47-year-old woman who had anterior neck swelling and bilateral breast tumors. histology of the tumor revealed diffuse large B-cell lymphoma. The patient underwent eight cycles of CHOP regimen and high-dose chemotherapy (HDC) with peripheral blood stem cell transplantation (PBSCT). Forty eight months after the PBSCT, there is no evidence of disease. The third case is a 38-year-old woman who had a right breast tumor. FNAC of the breast tumor showed ML and a CT scan of the chest revealed lymphadenopathy at the crus of the diaphragm. histology of the tumor revealed low-grade B-cell lymphoma of MALT type. The patient underwent six cycles of CHOP regimen and HDC supported by PBSCT. Eighteen months after the PBSCT, relapse lesions were detected in nodes of the neck, mediastinum and renal hilum. The patient received nine cycles of a THP-COP regimen.- - - - - - - - - - ranking = 4keywords = cycle (Clic here for more details about this article) |
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