ISSN:8756-0437    

DOI:10.1002/ssu.2980040402

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractMammary epithelial hyperplasia indicates an increased likelihood of carcinoma development as it does in other organs. Prospective studies have demonstrated that in the premammography era about 70% of women undergoing surgical biopsy had no increased risk of cancer and have little if any hyperplastic alteration. About 25% of women have well‐developed hyperplastic changes and have a risk elevation, controlled for age, of 1.5–2 times that of the general population. Less than 5% of women have atypical hyperplasia demonstrating some histologic features of carcinoma in situ, which indicates a risk elevation of 4–5 times. This is about one half the risk associated with microscopic carcinoma in situ. Therapeutic implications of these premalignant lesions rest predominantly in their indication for the heightened intensity of subsequent breast cancer surveillance and scre

ISSN:8756-0437    

DOI:10.1002/ssu.2980040403

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractIt is generally agreed that the best and possibly the only means to reduce mortality in breast cancer is to detect the disease in its early, most curable stage. This usually means detection when nodes are negative and often when the lesion is nonpalpable. The best method with which to achieve this goal is periodic examination including clinical study and mammography when the woman is apparently well, as is done in mass screening. This applies today to all women over 40 yr old. A baseline examination at age 35 yr is helpful. Radiation risk is today considered to be minimal, if any, and probably is not even measurable. Cost is important. The dedication of the screening institution is most important in this regard. The chief stumbling block is a lack of motivation on the part of subjects to accept or even demand the examination. This needs to be stimulated through contacts with women directly and with their physicians.

ISSN:8756-0437    

DOI:10.1002/ssu.2980040404

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe Action and Planning Committee on Breast Cancer Control was formed in 1970 by the American Cancer Society, based on their earlier successful experience with early‐detection programs for uterine cancer. The original intention was to support 12 centers for 2 years, but with the passage of the Conquest of Cancer Act in 1971, and the consequent availability of more funds for cancer programs, the American Cancer Society and the National Cancer Institute decided jointly to expand the program to 27 Breast Cancer Detection Demonstration Project Centers, with 280,000 women participating, who would be examined annually for 5 years. Data from the examinations, which included history, physical examination, mammo‐gram, and thermogram, were subjected to a continuing computer analysis. The thermogram was deleted after the second year. Although patients were randomly selected, there was an almost identical number of subjects in two age groups—35–49 years and 50–75 years. The results of the study are presented, and the importance of the program's efforts at breast self‐examination education as contained in the program's original protocol, i

ISSN:8756-0437    

DOI:10.1002/ssu.2980040405

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe background to the Halstedian era of breast cancer treatment is sketched, and the development of the changes in surgical treatment are outlined, with a review of the most important findings from the several clinical trials conducted to evaluate the alternative operative procedures. Included is a short description of operative techniques; also pathological examination of the operation specimen, and the use of radiation therapy when performing a segmental mastectomy are briefly described. This review is based almost entirely on observations from clinical trials conducted by the National Surgical Adjuvant Breast and Bowel Project.

ISSN:8756-0437    

DOI:10.1002/ssu.2980040406

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractAn unexpected rise in breast cancer mortality has been reported for 1984 and 1985 in white women below 50 years of age in the United States. During the preceding 10 years, there had been a progressive drop of approximately 1% in breast cancer mortality for each successive year. This recent increase in mortality occurred despite the increased use of adjuvant chemotherapy; it is most likely a direct result of the current tendency to downgrade the need for adequate primary therapy. Several recent prospective randomized studies that evaluated the relative efficacy of mastectomies of varying extent have shown a direct relationship between local control and long‐term survival. They also demonstrated that specific operative procedures were most effective for the appropriate clinicopathological stage of disease. Stage I cancers can be treated effectively by modified mastectomy, but radical mastectomy is superior for control of stage II and stage in disease. Inner‐quadrant cancers are most effectively managed by extended radical mastectomy, which includes excision of the internal mammary nodes. Excellent surgical technique was employed in all studies, which included observed follow‐up of 10–20 years. Optimal local control and long‐term survival were achieved by the appropriate operative

ISSN:8756-0437    

DOI:10.1002/ssu.2980040407

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractIn 1987 there were estimated to be approximately 130,000 new cases of breast cancer diagnosed in the United States. Presently, about 20–30,000 of these cases are treated with primary radiotherapy, although many more of the 90,000 stage I and II breast cancer cases are eligible for this form of treatment. Appropriate selection must be employed, including the size and site of the primary tumor, the size of the breast, the potential for multifocal disease, and the age of the patient. When proper selection is used, primary radiotherapy for stage I and II disease yields equivalent overall survival and NED survival when compared to traditional mastectomy. The benefit is preservation of the breast with good to excellent cosmesis in the vast majority of patient

ISSN:8756-0437    

DOI:10.1002/ssu.2980040408

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe development of the use of chemotherapy in the treatment of breast cancer is discussed. Its contribution in the primary management of this disease lies not only in the limited but consistent reduction in mortality, but it has helped to elucidate the biological complexity of breast cancer. Also, it has stimulated basic scientists and research physicians to integrate their efforts, which is expected to result in further clinical progress.

ISSN:8756-0437    

DOI:10.1002/ssu.2980040409

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractMetastatic breast cancer continues to take thousands of lives each year despite the advances in screening and adjuvant therapy. Chemotherapy in advanced disease is an intervention which can successfully lead to palliation (prolongation of quality survival) in the majority of women who are treated, but it does not constitute a curative intervention. New agents or innovative modalities will be needed to make a significant impact on the survival of this group of women.

ISSN:8756-0437    

DOI:10.1002/ssu.2980040410

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractInflammatory breast cancer is the most aggressive breast neoplasm and one of the most ominous solid tumors. Because of distinct clinical characteristics, diagnosis can usually be made on clinical grounds. Biopsy including the overlying skin may demonstrate dermal lymphatic invasion, although the absence of dermal lymphatic invasions should not deter aggressive therapy. Surgery or irradiation alone has little effect on the natural history of this disease since lymphatic invasion and distant metas‐tases are often present at presentation. Inflammatory breast cancer should be considered a systemic disease. Accordingly, aggressive combined modality therapy including multi‐drug chemotherapy, surgery, and irradiation have prolonged disease‐free survival and overall sur

ISSN:8756-0437    

DOI:10.1002/ssu.2980040411

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY