[Surgical treatment of breast cancer]. / Brystkraeft--kirurgisk behandling.

This short review of surgical treatment of breast cancer includes a description of indications and contraindications for the common surgical procedures as well as more recently introduced techniques. The latter are mainly operations performed in cooperation between breast and plastic surgeons and consist of reconstructive and oncoplastic procedures. The main surgical results are reviewed.

[Carcinoma in situ of the breast]. / Carcinoma in situ mammae.

Ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) represent a proliferation of malignant epithelial cells within the ducts of the breast without invasion through the basement membrane. It is assumed that all invasive carcinomas of the breast are preceded by DCIS or LCIS. However, it is not known what proportion of DCIS or LCIS--if left untreated--will progress to invasive carcinoma. Standard treatment for DCIS is breast-conserving surgery with free margins and radiation therapy. LCIS is usually treated by observation alone.

Mastectomy using ultrasonic dissection: effect on seroma formation.

Seroma formation is the most common complication after mastectomy. Among the several known etiological factors the surgical procedure used may be of importance for seroma formation. This prospective study was carried out to evaluate the ultrasonic energy dissection technique and its effect on seroma formation and other complications: 59 patients with operable breast cancer underwent modified radical mastectomy, performed in 30 of them with an Ultracision Harmonic scalpel and in 29 with scissors and electrocautery. In all cases a standard level II axillary dissection was performed with scissors. We found no differences in the outcome of surgery. Peroperative bleeding (median 300 ml, range 100-790 vs 300 ml, range 40-1400), drain volume (585 ml, range 130-1455) vs 645 ml, range 95-1570), seroma formation 50 (0-580) ml vs 105 (0-3775) ml and wound complications were about the same in both groups. In conclusion, neither clinical advantages or disadvantages of the ultrasound dissection technique were found.

[Conservative treatment of wound infection after breast cancer surgery]. / Konservativ behandling af sårinfektioner efter operation for mammacancer.

INTRODUCTION: The aim of this study was 1) to ascertain how patients with a wound infection after breast surgery are treated in other Danish surgical departments, and 2) to analyse our experience with conservative treatment of wound infections. MATERIAL AND METHODS: 1) A questionnaire sent to surgical departments in Denmark to access how these infections are treated; 2) a prospective analysis of our experience with conservative treatment of wound infections. RESULTS: 1) In 10 of the 20 departments, which perform breast surgery, wound infections were treated by reopening the wound in most cases. 2) Out of 1118 patients operated on for breast cancer, the incidence of wound infection was 3.6%. Ten per cent were admitted to other surgical departments and had their wounds reopened. Ninety-four per cent of the patients treated in our department were treated conservatively, and of these 90% were treated conservatively with repeated aspiration or replacement of the drain, 5% had spontaneous perforation of the wound abscess, corresponding to a small area of necrosis, and healed without operation. Five per cent had a major area of necrosis with underlying infections. These patients had their wound revised surgically with primary closure without complications. All the patients were given antibiotics. DISCUSSIONS: We conclude that wound infections after operations for breast cancer can be treated conservatively with good results.