Update on adjuvant hormonal treatment of early breast cancer.

Clinical trials conducted over the last two decades have demonstrated that 5 years of treatment with tamoxifen (TAM) after local treatment in postmenopausal patients with positive hormone receptor early breast cancer improves disease-free survival and overall survival. More recently, aromatase inhibitors (AI) have been tested in several randomized clinical trials in this setting. The studies have tested either AI versus TAM or different sequential approaches combining the two agents. While the most effective strategy remains to be determined, overall, incorporation of AI resulted in better disease-free survival, particularly in the worst-prognosis subgroup of patients. In addition, long-term treatment with AI was, in general, well tolerated. However, mature results are needed in order to be able to assess the effect in overall survival. The authors of this supplement paper include the key points of roundtable presentations and discussions of hormonal therapy in breast cancer by topic.

[Orbital metastases of breast cancer]. / Metástasis orbitarias del cáncer de mama.

Orbital metastases are a defined subgroup within ocular affection secondary to the distant spread of breast cancer. We review the published experience on the incidence of orbit extension from this type of tumour, with reference made to our experience as medical oncologists, together with the most common clinical features and the relevant aspects for imaging and histopathological diagnoses. The therapy for orbital metastases from breast cancer is included within the systemic therapy required by the distant spread of the disease, with some clinical benefits obtained from hormone therapy, chemotherapy and monoclonal antibodies. Palliative radiation and surgery may also play an important role in providing care to these patients. Although there are some published cases with long-term survival, the prognosis for these patients is poor, and new advances in knowledge and therapy are needed for this complication due to breast cancer.

[Evaluation through the EORTC questionnaires of long-term quality of life in patients with breast cancer in initial stages]. / Evaluación de la calidad de vida a largo plazo en pacientes con cáncer de mama en estadios iniciales mediante los cuestionarios de la EORTC.

BASIS: The objective of the present work is to evaluate the quality of life of a group of patients with breast cancer after a long follow-up time. METHODS: 104 patients with breast cancer in initial stages, of a total of 125 to whom the questionnaire was sent, have completed the general questionnaire QLQ-C30 and the module of the breast QLQ-BR23 of the EORTC in 2001, five years after their diagnosis. A subgroup of 48 patients had completed these questionnaires in 1996. The scorings of quality of life and the differences among the measurements of 2001 and 1996 have been evaluated, and groups organized according to the stage, the type of treatment, and the surgery have been compared. RESULTS: The scorings of quality of life are appropriate and similar in both periods (1996 and 2001). There are alterations in the sexual function and concern over the future. The differences between the type of surgery focus on the corporal image. There are not significant differences in the analyses according to the stage or according to the type of treatment. CONCLUSIONS: The scorings of quality of life indicate that the situation of these patients is satisfactory. The differences in the type of surgery are similar to the ones observed in the literature.

[Endoscopic resection of tumor of the renal pelvis]. / Resección endoscópica de tumor de pelvis renal.

We report on a patient who was submitted to percutaneous resection of a solitary, low grade urothelial transitional cell tumor of the renal pelvis. A review of the literature shoned endourologic treatment to be a valid in carefully selected cases. The measures to minimize the risk of tumor spread and the good results obtained are discussed. However, a longer follow up and larger series are necessary in order to draw definitive conclusions.

[Monoclonal gammopathy and osteolytic lesions as the initial manifestation of a metastatic hypernephroma]. / Gammapatía monoclonal y lesiones osteolíticas como primera manifestación de un hipernefroma metastásico.

We report on a patient with metastatic renal adenocarcinoma that had been detected following evaluation for monoclonal gammopathy associated with osteolytic lesions. When the foregoing associated conditions present, we must discard the presence of a myeloma. No objective data relating gammopathy with tumor behaviour are currently available.

[Bilateral adrenal masses during clinical staging of renal carcinoma]. / Masas adrenales bilaterales durante el estadiaje clínico del carcinoma renal.

We report a case of renal adenocarcinoma with bilateral adrenal masses at the time of diagnosis. Owing to the methods currently used for clinical staging, this association is no longer infrequently observed. Experience has demonstrated the value of the diagnostic techniques in this condition. The use of some of these techniques will depend on the findings during clinical staging of the tumor. Well-selected cases with metastasis to the adrenal gland can benefit from surgery.

[Duplication of the inferior vena cava associated with renal carcinoma]. / Duplicidad de vena cava inferior asociada a carcinoma renal.

Although uncommon, vascular anomalies of the inferior vena cava can have important consequences in urological oncologic surgery. A case of duplicated vena cava associated with clear cell renal adenocarcinoma is described. This type of tumor of the genitourinary system had been detected intraoperatively.