Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation

Fisher, B

doi:10.1097/00006534-198605000-00047

Cited by 24 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It occurs in 1-3% of patients with early-stage breast carcinoma treated with breast conservation therapy. [5][6][7] In the current study, regional lymph node recurrences, with or without simultaneous local or distant recurrence, occurred in only 3% of all patients with Stage I-II breast carcinoma treated with breast conservation therapy. The impact of regional recurrence with or without local recurrence on outcome has not been well established.…”

Section: Discussionmentioning

confidence: 50%

Prognosis after regional lymph node recurrence in patients with Stage I–II breast carcinoma treated with breast conservation therapy

Harris

Hwang

Seyednejad

et al. 2003

Cancer

View full text Add to dashboard Cite

A microkinetic model capable of describing multiple processes related to the conversion of natural gas to syngas and hydrogen on Rh is derived. The parameters of microkinetic models are subject to (intrinsic) uncertainty arising from estimation. It is shown that intrinsic uncertainty could markedly affect even qualitative model predictions (e.g., the rate‐determining step). In order to render kinetic models predictive, we propose a hierarchical, data‐driven methodology, where microkinetic model analysis is combined with a comprehensive, kinetically relevant set of nearly isothermal experimental data. The new, thermodynamically consistent model is capable of predicting several processes, including methane steam and dry reforming, catalytic partial oxidation, H2 and CO rich combustion, water‐gas shift and its reverse at different temperatures, space velocities, compositions and reactant dilutions, using the measured Rh dispersion as an input. Comparison with other microkinetic models is undertaken. Finally, an uncertainty analysis assesses the effect of intrinsic uncertainty and catalyst heterogeneity on the overall model predictions. © 2009 American Institute of Chemical Engineers AIChE J, 2009

show abstract

Section: Discussionmentioning

confidence: 50%

Prognosis after regional lymph node recurrence in patients with Stage I–II breast carcinoma treated with breast conservation therapy

Harris

Hwang

Seyednejad

et al. 2003

Cancer

View full text Add to dashboard Cite

show abstract

“…Approximately half of them recur in the form of invasive disease which is associated with signifi cantly reduced overall survival; whereas, the other half recur as DCIS (2). Postoperative radiotherapy reduces the recurrence rate to 7-9% (3)(4)(5), of which about half are invasive (4;6). In a large series with 15 years follow up, the fi rst local failure rate was 16%, 2/3 as an invasive cancer, even with adjuvant radiotherapy (7).…”

Section: Introductionmentioning

confidence: 99%

Biological Markers Predictive of Invasive Recurrence in DCIS

Nofech‐Mozes

Spayne²,

Rakovitch³

et al. 2008

Clinical medicine. Oncology

View full text Add to dashboard Cite

DCIS is a heterogeneous group of non-invasive cancers of the breast characterized by various degrees of differentiation and unpredictable propensity for transformation into invasive carcinoma. We examined the expression and prognostic value of 9 biological markers with a potential role in tumor progression in 133 patients with pure DCIS treated with breast conserving surgery alone, between 1982-2000. Histology was reviewed and immunohistochemical staining was performed. Pearson correlation coeffi cient was used to determine the associations between markers and histopathological features. Univariate and multivariate analysis examined associations between time to recurrence and clinico-pathologic features and biological markers. Median age at diagnosis was 55 years (25-85). With a median follow up of 8.91 years, 41/133 patients recurred (21 as invasive recurrence). In this cohort 13.5% had low, 43% intermediate and 42% high nuclear grade. Comedo necrosis was found in 65% of cases. Expression of ER (62.4%), PR (55.6%), HER2/neu (31.6%), MIB1 (39.8%), p53 (22.6%), p21 (39.8%), Cyclin D1 (95.5%) calgranulin (20.5%), psoriasin (12%), was found in DCIS. HER2/neu was overexpressed in 45% that recurred as DCIS and 42.9% that recurred as invasive cancer, and only in 26.1% in cases that never recurred. On univariate analysis, HER2/neu overexpression was the only marker associated with an increased risk for any recurrence (p = 0.044). The hazard ratio for recurrence for HER2/neu positive DCIS was 1.927 (confi dence interval 1.016-3.653) compared to HER2 negative DCIS. On multivariate analysis, HER2/neu overexpression remained the only independent variable signifi cantly associated with any recurrence (p = 0.014) and with invasive recurrence (p = 0.044). This data suggest that HER2/neu testing may become an important parameter in the management of DCIS and the treatment of cases with positive HER2/neu status could be modifi ed accordingly, similar to the current approach for HER2/neu positive invasive disease.

show abstract

“…Je nach Literaturquelle wurden Klassen von invasiven Karzinomen mit Durchmessern von bis zu 5 mm (25,27,37,50,65,76), von bis einschließlich 5 mm (31,32,42,47,57), von bis zu 10 mm (6, 23, 39, 58, 65, 75) und von bis einschließlich 10 mm (7, 14, 19, 34, 44, 53, 74) untersucht und mit den genannten Begriffen belegt. Tumorfreie Lymphknoten waren für viele Autoren (6,7,14,25,42,49,53,57,65,74,75) eine Grundvoraussetzung für die Abgrenzung gegenüber den größeren Mammakarzinomen, wurden jedoch nicht in allen Fällen zur Bedingung gemacht (20,27,31,32,39,44,47,58). Wenige andere Autoren verwandten zur Abgrenzung von "microinvasive" (52) oder "minimally invasive" (56) Karzinomen von größeren Malignomen anstatt einer Größenbestimmung Invasionsmuster wie die größte Invasionstiefe bis einschließlich 5 mm (52, 57) oder die größte relative Stromainvasion durch die Basalmembran von bis zu 10 % des Tumorumfanges (50, 56, 64).…”

Section: Definitionunclassified

Therapie und Prognose des kleinen Mammakarzinoms

Kieback

Beller²,

Nitsch³

et al. 1990

Geburtsh Frauenheilk

View full text Add to dashboard Cite

A retrospective clinical study included 1283 patients with breast cancer. 307 of 762 tumours with known diameter (mm) were classified as stage pT1 (TNM, 70). Four groups were formed to compare the prognosis in subgroups of pT1 cancers: 0-5 mm (n = 22), 6-9 mm (n = 22), 10 mm (n = 53) and 11-20 mm (n = 210). A comparison of three types of surgery was made: Radical subcutaneous mastectomy (12), bilateral modified subcutaneous mastectomy (10, 11), and modified radical mastectomy (Auchincloss, 3). Both forms of subcutaneous mastectomy were combined with adjuvant postoperative radiotherapy to the side of the tumour. In this trial, patients were younger at diagnosis than usually stated in the literature. Small breast cancers had the same localisation and histology as large ones. Axillary lymph node metastases were identified from a tumour diameter of 6 mm upwards. Bilateral tumours were seen in 2 of 22 patients with tumours less than or equal to 5 mm. Multifocal growth was observed also in the same size range. Histologically different simultaneous invasive unilateral cancers were seen starting at a diameter of 8 mm of the larger tumour. Systemic metastases were observed in tumours of 10 mm in diameter. Local recurrences occurred in breast cancers with a diameter of 2 mm and more. There were no recurrences in the area of the nipple or areola in pT1 cancers. Small breast cancers did not appear to be biologically different from larger lesions. No prognostic subgroups of pT1 were evident beyond the established TNM staging. Disease-free survival was not significantly different between the three surgical approaches. Local recurrence was significantly less frequent after breast-conserving surgery. A negative influence of local recurrence on the prognosis was observed to a similar extent irrespective of the type of surgery. The concept of "minimal breast cancer" suggesting ablative surgery for a heterogeneous group of preinvasive and small invasive lesions is outdated. The different forms of subcutaneous mastectomy are a therapeutic alternative in the context of breast-conserving surgery of small infiltrating breast cancers. Especially the modified subcutaneous mastectomy (Beller) combines a good cosmetic result without prognostic impairment and with a potential reduction of the risc of contralateral breast cancer. Further potential applications include prophylactic treatment of high-risk patients with preinvasive lesions.

show abstract

Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation

Cited by 24 publications

References 0 publications

Prognosis after regional lymph node recurrence in patients with Stage I–II breast carcinoma treated with breast conservation therapy

Prognosis after regional lymph node recurrence in patients with Stage I–II breast carcinoma treated with breast conservation therapy

Biological Markers Predictive of Invasive Recurrence in DCIS

Therapie und Prognose des kleinen Mammakarzinoms

Contact Info

Product

Resources

About