ISSN:0735-7907    

DOI:10.3109/07357909209024802

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Breast conservation, utilizing limited excisional breast surgery and axillary lymph-adenectomy followed by radiation therapy can achieve excellent local I regional control and survival in many breast cancer patients. With average sized tumors, where larger volume resections are performed the results can equal that of the modified radical mastectomy. However, smaller tumors do very well with breast removal so it is a challenge to demonstrate that the long-term results of breast conservation in earlier stage disease are equivalent to mastectomy. Small or occult tumors do not always indicate localized disease and suitability for breast conservation depends on a combination of factors: tumor size and ratio of tumor to breast volume, cell type, location of tumor, obtaining clear margins, the mammography picture, multicentricity, and the probability of axillary lymph node involvement. It is important to select patients for conservation where an equivalent survival can be expected. Recurrence in the radiated breast usually is diagnosed and treated at a more advanced stage than the disease which was initially treated conservatively. It is difficult to manage and carries a poorer prognosis.

ISSN:0735-7907    

DOI:10.3109/07357909209024803

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

ISSN:0735-7907    

DOI:10.3109/07357909209024804

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

There is now general agreement that treatment with conservative surgery and radiation therapy yields survival equal to mastectomy with the advantage of organ preservation for properly selected patients. When competently performed, such treatment gives highly satisfactory cosmetic results and acceptably low rates of local tumor recurrence. However, there remain numerous controversies concerning patient selection for this treatment option. The factors involved in patient selection may be grouped into three categories: patient factors; clinical factors; and pathologic factors. This article reviews their use. Because breast cancer has a long natural history, long follow up of patients is required for ultimate proof of the relative merits of different selection or treatment policies. However, due to the increasing numbers of patients being treated with conservative surgery and radiotherapy, it appears likely that many of these questions will be answered within the next decade.

ISSN:0735-7907    

DOI:10.3109/07357909209024805

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

The appropriate management of the breast cancer patient with early stage disease is a controversial, frustrating issue. If laboratory tests could accurately predict tumor behavior, however, the clinician and patient would be greatly aided in their treatment decisions. Although imperfect, there are several new and significant factors that can be used to predict patient prognosis; the most promising and well studied of these factors are DNA flow cytometry measurements. There are at least two estimates of tumor aggressiveness that we can obtain from DNA flow cytometry: one is an estimate of the tumor DNA content or ploidy and the other is an estimate of the tumor proliferative capacity. These measurements have their greatest clinical impact in the node negative patient predicting for relapse-free survival and overall survival. Estimates of proliferative capacity are independent predictors of patient prognosis. Estimates of DNA content are at times controversial and yet still are helpful in distinguishing prognostic subgroups of proliferative activity and may have additional clinical relevance. This discussion will summarize the data obtained from DNA flow cytometry measurements supporting their use as clinically important markers of prognosis in the node-negative patient.

ISSN:0735-7907    

DOI:10.3109/07357909209024806

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

ISSN:0735-7907    

DOI:10.3109/07357909209024807

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

ISSN:0735-7907    

DOI:10.3109/07357909209024808

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

ISSN:0735-7907    

DOI:10.3109/07357909209024809

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor