These findings suggest an aetiological association between life stress and breast cancer.

and conclusions Three patients with primary hepatic tumours were treated by selective arterial embolisation with gelatinfoam fragments to induce necrosis. In the two with histologically proved hepatocellular carcinoma ultrasonography suggested that necrosis had been induced, as did the rapid initial falls in serum a-fetoprotein concentration by 95 and 81% of the original values respectively. Treatment was continued with a course of adriamycin, and both patients remained well and symptom free at 10 and 12 months. In the third patient, who had an expanding and highly vascular benign hepatic adenoma associated with use of a contraceptive pill, embolisation obliterated the tumour mass. Tumour embolisation should be regarded as only the first step in managing hepatocellular carcinoma and as a means of reducing appreciably the viable tumour mass before chemotherapy. It may be used as the primary and definitive treatment in patients with benign liver tumours.

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Eighteen patients with a cholangiocarcinoma involving the hilum of the liver, and one patient with a carcinoma of the gall bladder causing obstruction of the common hepatic duct, have been treated with bile drainage using a U-tube (8 patients) or a percutaneous transhepatic catheter (11 patients) followed by internal radiotherapy with 192iridium wire. The median survival is 11 months, and 9 patients (47 per cent) have survived for 12 months or longer. The addition of internal radiotherapy may be beneficial to patients with hilar cholangiocarcinoma causing biliary obstruction in whom bile drainage can be established.

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