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ABSTRACT: We report three cases of idiopathic granulomatous mastitis that occurred in women of reproductive age (range, 25 to 36 years). These patients presented with breast masses of 2.5, 7, and 10 cm. One patient also had erythema nodosum. On biopsy specimens, the characteristic histopathologic features of granulomatous inflammation, centered on mammary lobules, were present in each case. In only one case was a specific diagnosis of granulomatous mastitis rendered based on the results of the biopsy; this patient received oral prednisone with prompt shrinkage of the breast mass to 20% of its original size. This residual mass was then resected. The remaining two patients were observed after biopsies were performed, with one experiencing a local recurrence after 5 weeks. The optimal therapy for idiopathic granulomatous mastitis has not been established, and we discuss treatment options, based on these three cases and those previously reported.
Archives of pathology & laboratory medicine 09/1994; 118(8):822-5. · 2.58 Impact Factor
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ABSTRACT: Conservative surgery followed by postoperative radiation is considered equivalent to a modified radical mastectomy (MRM) for the treatment of early breast cancer. It cannot be assumed that results from selected academic centres are equivalent to those obtained in the general community setting, because there may be differences in patient selection or surgical or radiotherapy techniques that may adversely affect outcome. A quality-control study of women who were seen at the British Columbia Cancer Agency and were treated by partial mastectomy (PM) was begun in 1983. Eighty-four women who underwent conservative surgery between January 1979 and November 1982 and were referred to the British Columbia Cancer Agency were matched with 84 women who underwent MRM. The mean follow-up was 10.5 years. At 10 years disease-free survival in both groups was 63%. Survival overall for the PM group was 72.6% and for the MRM group was 69%. The survival rate decreased with increasing size of the tumour and increasing number of nodes. In women with lymph-node involvement there was a survival advantage for those treated by PM and radiation compared with those treated by MRM. The woman's age at diagnosis did not affect these findings. Recurrence and complication rates were similar in both groups, and treatment was considered equivalent.
Canadian journal of surgery. Journal canadien de chirurgie 09/1992; 35(4):383-7. · 1.05 Impact Factor
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Recent results in cancer research. Fortschritte der Krebsforschung. Progrès dans les recherches sur le cancer 02/1989; 115:28-35.
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ABSTRACT: Despite recent developments in the treatment of breast cancer, metastatic breast cancer remains an incurable disease. Postoperative adjuvant treatment may improve the survival of a subgroup of node positive, Stage II breast cancer patients, but the proportion of failures is still high. Preoperative adjuvant chemotherapy, an example of a new approach in scheduling of available agents, is based on sound theoretical and experimental principles. In this report, the authors summarize the background data on the rationale for preoperative adjuvant chemotherapy and present preliminary results of this study in which preoperative treatment starting with one course of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) was given to newly diagnosed patients with breast cancer. Analysis of the first 43 patients given such treatment has shown that the side effects were comparable to those seen in patients treated with conventional postoperative chemotherapy, and that the delay time between diagnosis and starting chemotherapy has been substantially reduced compared to the historic group of patients. Additional aspects of this study include the introduction of fine-needle aspiration as the only diagnostic method for obtaining the tissue diagnosis of breast cancer, as well as a more intensive interaction between the surgeons from private practice and the oncology institute.
Cancer 09/1985; 56(4):719-24. · 4.77 Impact Factor
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Progress in clinical and biological research 02/1985; 201:77-87.
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Recent results in cancer research. Fortschritte der Krebsforschung. Progrès dans les recherches sur le cancer 02/1985; 98:99-105.
