1/8. pregnancy and breast cancer.Breast cancer in association with pregnancy and lactation is rare, but presents a therapeutic problem of considerable magnitude. The outlook for such patients is less favorable than that of nonpregnant, nonlactating women, probably because the stage of the disease is more advanced when it is discovered. The most significant factor in the poorer prognosis is physician delay in diagnosis and therapy. When mastectomy is carried out early in pregnancy, the operation can be as effective as in nonpregnant women of the same age groups. It is emphasized that when pregnancy and breast cancer are found concurrently, prompt therapy for the cancer should be undertaken. Interruption of pregnancy in nondisseminated breast cancer is of little value. If pregnancy is near term when the diagnosis of disseminated breast cancer is made, the desire of the husband and wife for a child should be considered. A modest delay in therapy to allow for delivery probably has no deleterious effect. castration should be withheld and used only for the patient with metastatic disease. There may be a place for prophylactic castration in the treatment of disseminated disease, but its role is yet to be clearly defined. Subsequent pregnancies in a patient with axillary spread at the time of mastectomy are contraindicated, because of the high rate of treatment failure and decreased rate of survival. In patients desiring future pregnancies following mastectomy, a period of observation of at least 2 years seems wise. At the end of that period, if clinical evaluation, laboratory values, roentgenographic studies, and isotopic bone scanning are negative for disseminated disease, subsequent pregnancies seem safe. Prompt evaluation of any breast mass found during pregnancy and lactation should be carried out by needle or operative biopsies under local anesthesia. Although the prognosis of the pregnant or lactating woman with breast cancer is generally favorable, numerous long-term survivals are encountered in those women who undergo prompt mastectomy early in pregnancy. The former pessimistic outlook for such patients seems unjustified. With modern methods of diagnosis and treatment, therapy can be effective and successful.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. Veno-occlusive disease of the liver following chemotherapy with mitomycin C and doxorubicin.A 54-year-old woman with metastatic breast cancer developed veno-occlusive disease of the liver following chemotherapy with mitomycin C and doxorubicin. The dose of mitomycin C received by this patient was much lower than that previously described to cause this complication. As both these drugs are used widely physicians should be aware of this complication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/8. Breast cancer after treatment for osteosarcoma.Two cases of patients with primary osteosarcoma who developed subsequent new primary infiltrating ductal carcinoma of breast are presented. The relationship of irradiation from diagnostic radiology, chemotherapy given, and possible genetic factors are discussed. A recommendation for the lifetime follow-up program of a patient with osteosarcoma should include careful attention to breast self-examination and regular breast examination by the attending physician.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/8. adenocarcinoma of the breast associated with silicone injections.A 42-year-old woman developed inflammatory breast cancer in a breast with "silicone mastitis" 12 years after bilateral breast augmentation with liquid silicone injections. Despite aggressive local and systemic therapy, the patient died of her disease. Breast cancer arising in silicone-injected breasts is reported infrequently, and physicians caring for patients with silicone breast injection augmentation should be aware of this potentially fatal association with breast cancer.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/8. Paget's disease of the male breast.Paget's disease of the breast is a malignant lesion consisting of Paget cells in the epidermis and an underlying ductal carcinoma of the breast tissue. It is estimated that perhaps 3% of female breast carcinoma cases are Paget's disease. If one estimates male breast carcinoma to be approximately 1% of the rate in the female population, then Paget's disease in men is clearly a rare clinical event. Although Paget's disease has an epidermal component, little attention has been given to this entity in the dermatologic literature. We present a case report of this disease in an elderly male patient and comment on the clinical features which should alert the physician to the presence of the malignancy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/8. Male breast cancer: three case reports and review of the literature.Carcinoma of the breast occurs so infrequently in men that it is not at al well known either to patients or physicians. The causes of breast cancer in men are unknown. The most common clinical manifestation of breast cancer in men is a painless, firm subareolar mass or a mass in the upper outer quadrant of the breast. diagnosis can be confirmed by fine-needle aspiration or surgical biopsy. Infiltrating ductal carcinoma is the predominant histologic type. After primary surgical treatment, men with axillary lymph node metastasis should receive adjuvant systemic chemotherapy. The use of radiation therapy for local control of the disease is recommended if there is invasion of the chest wall. Because most men with carcinoma of the breast have estrogen and progesterone-receptor positive tumors, breast cancer in men is likely to respond to hormonal manipulation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/8. Breast lumps in men: four case reports and a literature review.Four cases of men who consulted their family physicians because of breast lumps are reported. Their final diagnoses were as follows: intraductal carcinoma, gynecomastia, seminoma, and lipoma. A review of the literature revealed a lack of data on the prevalence of breast lumps among male adults, considerable ambiguity in clinical definitions of the term "gynecomastia," and a general uncertainty about the prevalence of malignancy in such lesions. Further epidemiologic studies are needed to determine the true prevalence and nature of breast lumps in men.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/8. incidence of autoimmune disease in patients after breast reconstruction with silicone gel implants versus autogenous tissue: a preliminary report.OBJECTIVE: To test the hypothesis that there is a higher incidence of autoimmune disorders in patients who have undergone breast reconstruction with silicone gel implants rather than autogenous tissue. DESIGN: Prospective study. SETTING: Tertiary referral center dealing exclusively with cancer. patients: All female breast cancer patients who underwent breast reconstruction between January 1986 and March 1992. patients were nonrandomly assigned to breast reconstruction with one of the following four methods: (1) silicone gel implant only, (2) latissimus dorsi flap with implant, (3) latissimus dorsi flap without implant, and (4) transverse rectus abdominis flap. The first two groups made up the implant cohort and the last two groups the autogenous tissue cohort. Selection of reconstructive method was made on clinical grounds and was based on both physician and patient preference. MAIN OUTCOME MEASURES: Documented diagnosis of autoimmune disorder by Board-certified rheumatologist. Results: Three hundred eight implants were used in 250 patients, and 408 reconstructions with tissue were performed on 353 patients. The two groups were similar in age and tumor stage. The two groups contributed 615.8 and 663.4 person-years of follow-up, respectively. One patient from each group (< 0.5%) had a documented occurrence of an autoimmune syndrome requiring therapy. Both cases were considered mild, and after initial low-dose steroid therapy, both patients are now off steroids. CONCLUSION: The incidence of autoimmune disease in mastectomy patients receiving silicone gel implants is not different than in patients who had reconstruction with autogenous tissue.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |