[Breast-preserving treatment of breast cancer and peroperative curietherapy]. / Traitement conservateur du cancer du sein et curiethérapie peropératoire.

From May 1988 to December 1990, 35 patients benefitted from a breast-conserving treatment (tumor resection with at least 1 cm of free margin, axillary dissection and peroperative brachytherapy). The iridium sources were introduced 24 h later, delivering between 15 to 17.5 Gy. Three weeks later an additional course of external radiation delivered a dose of 50 Gy in 5 weeks to the whole breast. In this series, only very early breast lesions were included and no patient received additional chemotherapy. Due to the short period of observation, we only report on the acute side effects even if until now we have not seen any case of tumor relapse. We did not observe any major complications after this combined approach: only three patients developed a local infection requiring antibiotics. Esthetic evaluation is quite encouraging with all women showing good and excellent results from the physician's and patient's points of view. This approach seems to be quite interesting cosmetically as it allows to correct the breast shape while preserving an adequate position of the implant and so preserving a good oncological approach.

[Implanted venous access system in oncology. Review of 296 cases]. / Voies d'abord veineux en oncologie par chambre implantable. Revue de 296 cas.

The authors present their experience of the use of a totally implanted vascular access system, at the Institut Jules Bordet. Between 1983 and 1988, 296 catheters were implanted in 289 patients. The average venous access period using this system was 232 days. The complication rate was only 0.36/1000 days of venous access. The totally implanted vascular system can provide a comfortable and reliable method of venous access in patients requiring prolonged intravenous chemotherapy.

[Morbidity of surgical treatment for advanced cancer of the breast after irradiation]. / Morbidité du traitement chirurgical du cancer due sein avancé après irradiation.

The authors reviewed the medical files of 100 patients with locally advanced breast cancer (stage III), treated in the department of surgery of the Institut Jules-Bordet between 1974 and 1988. All patients received preoperative radiotherapy (average total dose of 45 Grays). This preoperative irradiation was associated with chemotherapy in 74% of patients. All patients subsequently underwent surgery and a modified radical mastectomy was performed in 92% of cases. Our data analysis reveals an incidence of 25% of local wound infections, 34% of delayed wound healing, 63% of seroma formation and 22% of lymphoedema of the upper limb. The local postoperative morbidity appears to be increased in patients preoperatively irradiated. This indicates that preoperative chemotherapy may be preferable in these patients to minimise the local postoperative morbidity and its impact on the quality of life.

Local postoperative morbidity following pre-operative irradiation in locally advanced breast cancer.

The authors have reviewed the medical files of 100 patients with locally advanced breast cancer (Stage III), who were treated in the Department of Surgery at the Institut Jules Bordet between 1974 and 1988. All patients received pre-operative radiotherapy (average total dose 45 Gy), which was associated with chemotherapy in 74% of patients. All patients were subsequently subjected to surgery, using a modified mastectomy in 92% of cases. Our data reveal an incidence of 25% local wound infection, 34% delayed wound healing, 63% seroma formation and 22% lymphoedema of the upper limb. It seems that local postoperative morbidity is increased in patients pre-operatively irradiated. This indicates that pre-operative chemotherapy may be preferable in these patients to minimize the local postoperative morbidity and its impact on the quality of life.