Images Figs. 6-8 Figs. 9-11 Figs. 1-3 Figs. 4-5 Fig. 13

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SUMMARY.-A retrospective detailed study of 272 cases of breast carcinoma treated by radical mastectomy was published by Hamlin (1968). An (McWhirter, 1957), delay (Registrar General, 1967), clinical stage (Paterson, Tod and Russell, 1939), axillary node involvement (Myers, Axtell and Zelen, 1966), size of axillary nodes (Fisher, Slack and Bross, 1969), internal mammary node involvement (Handley and Thackray, 1954), malignancy grading of tumour (Bloom, 1950), host response (Hamlin, 1968), hormone balance (Hayward, Bulbrook and Greenwood, 1961), serum cholesterol levels (Juret, Aubert and de Kaou6l, 1967), treatment (Bloom, Richardson and Harries, 1962).It is clear from this list that many of these factors are interdependent. Age and menopausal status are related and both are probably related to hormone balance and perhaps to serum cholesterol levels. The size of the tumour, the delay in seeking advice, the clinical stage, and the node involvement are almost * Present address:

Five cases of aspergillosis complicating Hodgkin's disease and leukaemia are reported. The organs involved were: lungs (all five cases), stomach (Case 3); brain and meninges (Case 4); heart, kidneys, spleen, thyroid, and liver (Case 2). Cultures ofAspergillus fumigatuswere obtained from the post-mortem tissues of three patients.All the lesions in Case 2 were suppurative. The other four cases had non-suppurative lesions characterized by spreading coagulation necrosis with peripheral hyperaemia, exudation, and haemorrhage. Invasion and occlusion of blood vessels occurred frequently.The various factors that may be responsible for the initiation and progression of the fungal infection are discussed. The available evidence suggests thatAspergillus fumigatuscan produce toxic metabolites which are able to cause tissue necrosis and vascular damage. In patients suffering from neoplastic conditions of the lympho-reticular system, especially if steroid hormones or radiomimetic drugs are given, spreading, necrotizing lesions can develop unchecked by antibody or cellular defences.

SUMMARY.-An analysis of 101 cases of breast carcinoma occurring in patients under 35 years of age is presented with details of clinical stage, site, size and histological appearances of the tumour. Various factors are correlated with survival and the prognosis of the patient under 35 years is found to be closely related to the histological appearances of the tumour, which are reflected in the clinical stage at presentation. The question of treatment of carcinoma of the breast in the young woman is discussed.