Fruit for thought: Low‐temperature microwave hydrothermal processing of orange peel not only enables the separation of the major components but also adds further value through the production of other high‐value products: pectin and D‐limonene, together with a rare form of mesoporous cellulose, are produced in a single step, without added acid. A process temperature change enables the conversion of D‐limonene to α‐terpineol.
A few studies have suggested a relatively better prognosis for breast cancer (BC) cases reporting a positive family history (FH). We aimed at comparing the survival of patients according to FH in a large hospital-based series of 1,278 BC cases. Information on FH for BC was obtained at diagnosis by interview. All cases reporting a first-or second-degree FH for breast carcinoma were compared with cases without FH. Overall survival was estimated using a product-limit method. Hazard ratios (HRs) and the corresponding 95% confidence intervals (95% CIs), adjusted for confounding factors, were computed using proportional hazard models. Breast cancer (BC) is the most common cancer in women in developed countries and the total number of living BC patients is growing because of increasing crude incidence rates, early detection and longer survival. A positive family history (FH) of BC is a well-known risk factor, 1 and it is widely believed to account for 6 -19% of all new BC cases. 2-4 About 20% of women with BC have a positive FH and a smaller fraction, 4 -10%, have hereditary BC. 5,6 Based on some theoretical and experimental considerations and on the hypothesis that survival is significantly influenced by primary genetic factors, better prognosis for BC cases reporting FH has been suggested.Studies on survival in familial BC are inconclusive and results vary considerably because of the source of patients, eligibility criteria and definitions of FH. 7 FH has been associated with increased survival, 8 -14 decreased survival 15,16 and unchanged survival. [17][18][19][20][21][22] Some bias (i.e., lead-time/length bias/ascertainment bias) affecting comparisons and improved survival, found in cases reporting a positive FH, may be due to early diagnosis. Women with FH, particularly first-degree FH, may be more prone to screening procedures or to self-examination (as a result of a higher awareness caused by BC FH); and an earlier stage distribution may explain, at least partly, the different prognosis.Our study, derived from a large hospital-based series of BC cases previously published, 23 compares survival rates and explores the hypothesis of a different prognosis for subjects with a positive FH. MATERIAL AND METHODSA total of 1,278 invasive BC cases, residing in the Florence area at the time and operated on by the same surgeon (GC) between 1989 -1997, were analysed. A detailed description of our study design has already been published. 23 All cases had invasive carcinomas histologically verified and were submitted to surgical treatment and axillary dissection of at least levels I and II.The surgical database provides information on the date of birth, date of diagnosis, site and laterality of the BC. In addition, it provides information about initial surgical treatment and radiotherapy and/or chemotherapy schedules. Information about pathologic size and lymph node status according to pathologic TNM classification was available for all cases.Oestrogen and progesterone receptor status was collected from histopathologic results...
The proportion of women who complained of (or manifested at the physical examination) a minor or major disability of the arm in our study was high. The impact of these functional problems in terms of quality of life should also be assessed, but it is our impression that there is need for much greater attention to the issue of long-term survivor sequelae.
Frozen section (FS) diagnosis was routinely performed in a large series of nonpalpable breast lesions from 1977 through 1991. The original FS diagnoses of 672 patients were classified in four categories (1 = benign lesion, 2 = in situ carcinoma, 3 = invasive carcinoma, 4 = deferred diagnosis) and compared with the diagnoses obtained at review of the permanent paraffin sections to estimate the accuracy of FS. A review of the mammographic pattern of the lesion was also performed. Frozen section diagnostic conclusion was deferred to permanent paraffin sections in only 22 cases (3.3%). Benign or malignant (grouping in situ and invasive carcinomas) FS diagnoses were accurate in 623 of 650 cases (95.8%). Overall, the prevalence of malignant lesions was 44.8% with a benign/malignant ratio of 1.2. The diagnosis was modified on the basis of permanent sections in 27 cases (4.2%) with three false positives and 24 false negatives. Sensitivity and specificity of FS diagnoses were 91.7 and 99.2%, respectively. When the comparison between FS and histologic diagnoses was analyzed according to the mammographic pattern, sensitivity among patients with microcalcifications as the only alteration was lower (88.8%) than among patients with opacities (94.9%). On the basis of these results, FS is to be considered a feasible and reliable diagnostic procedure in nonpalpable breast lesions, particularly in cases excised because of a mammographic opacity that is identifiable on gross examination of the surgical specimen.
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