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The homogeneity of the schemes for follow-up care after curative surgical treatment of early breast cancer is still a matter of debate in Germany. We investigated whether symptom-oriented follow-up is equivalent in terms of survival rates to conventional surveillance based on scheduled tests. Patients and Methods: In a prospective, non-randomised, multicentre cohort study carried out between 1995 and 2000, 244 patients underwent a conventional follow-up (scheduled laboratory tests including CEA and CA 15-3, chest X-rays and liver ultrasound). 426 patients were monitored in a symptomoriented manner (additional tests only in the case of symptoms indicating possible recurrence). Mammography, structured histories and physical examinations were done regularly in both branches. 1,108 patients did not participate in the project. They represent ‘real world patients’, unaffected by the implications of a study. Results: The symptom-oriented follow- up group produced results not inferior to those of the intensive one (p < 0.05) in terms of overall and relapse-free survival. Furthermore, no difference was indicated in terms of overall survival between study participants and the ‘real world patients’ (p = 0.316). Conclusion: The results confirm that regular imaging and laboratory tests have no relevant effect on overall survival of patients after curative primary therapy of early breast cancer and support the implementation of a symptom-oriented routine follow-up.

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Serum-zinc-levels were evaluated in patients with breast cancer in relation to the various stages. Patients with metastatic breast cancer had significantly depressed zinc-levels, wereas patients with disease apparently localized to the breast and draining lymphnodes had nearly normal serumzinc levels. It appears that the determination of serumzinc in breast cancer patients may be of value in discriminating between localized and metastatic disease.

In this study we investigated the function of the obstructed small bowel of the rat, the behaviour of the mucosal enzymes, the metabolic changes of the small bowel wall and the morphology of the mucosa. We found a decrease of passive transport of 3H-Antipyrine which was equal after 24 and 48 hrs. The active transport of 14C-Glucose was found to be progressively inhibited after occlusion. The metabolic enzymes SDH, G-6-PDH, and GOT remained unchanged, LDH was increased after 48 hrs, which can be explained by enzyme induction. The lactate-pyruvate ratio in the tissue of the obstructed bowel was 3 times as high as in the controls. The brush-border enzymes maltase and especially the alkaline phosphatase are decreased with progressive obstruction, which probably is caused by diffusion into the lumen. By electron-microscopy there are no changes in the brush-border membrane but a swelling of mitochondria which is caused by hypoxia.

The results of treatment of early gastric carcinoma were analysed in 65 patients. In 33 patients the operation was performed 5 years ago. The 5-year-survival rate was 70%. Prognosis was predominantly influenced by the histology of the tumour. Signet ring cell and anaplastic early carcinomas (diffuse type) had a worse prognosis than intestinal (differentiated) forms. Carcinomas localised wholly in the mucosa had no better prognosis than those penetrating into the submucosa. There is no choice of surgical method according to prognostic criteria as the diagnosis "early gastric carcinoma" can be made only postoperatively from the resection material. Bioptic proof of carcinomatous gastric mucosal changes requires full observation of the rules of cancer surgery.

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