ABSTRACT
INTRODUCTION: The essential issue in conservative treatment is the quality in breast preservation. When risk factors for local relapse exist, a tumour bed boost is required, but the boost choice remains controversial. Prospectively, we studied long-term toxicity, cosmetic outcome and prognostic factors. MATERIALS AND METHODS: After conservative treatment, 115 patients received a single dose of 7 Gy HDR-brachytherapy (HDR-BT) boost between June 1996 and December 2005. Late toxicity was assessed using the LENT-SOMA scale. For esthetic assessment, a subjective scale was used for patients and a modified Fehlauer scale for physicians. Mean age was 56.6 years. Invasive ductal carcinoma (78 %) and lumpectomy (60 %) were predominantly reported. 48 % received chemotherapy (CT). RESULTS: Regarding toxicity, 39 % of patients reported breast pain, 75 % fibrosis, 56 % telangiectasias, 19 % lymphoedema, and 51 % retraction/atrophy. Concerning management, 22 % of patients with pain and 45 % with lymphoedema were treated. The esthetic result was found satisfactory by 96 % of the patients and 85 % of the physicians. Fibrosis was influenced by CT and a larger irradiated volume and telangiectasias by a greater implant volume. CONCLUSIONS: HDR-BT boost shows good cosmetic effects with acceptable toxicity. Patients overestimate the esthetic outcome. LENT/SOMA is useful to assess chronic toxicity (AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Breast/radiation effects , Breast/surgery , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Brachytherapy/adverse effects , Breast Neoplasms/pathology , Mastectomy, Segmental , Prospective Studies , Dose Fractionation, Radiation , Treatment OutcomeABSTRACT
BACKGROUND AND PURPOSE: Conservative treatment represents the current therapy for early-stage breast cancer. When risk factors for local relapse exist, a tumour bed boost is required. Retrospectively, we evaluated the prognostic factors influencing local recurrence (LR), overall survival (OS) and disease-free survival (DFS). MATERIAL AND METHODS: After conservative treatment, 210 patients received a single-dose HDR brachytherapy (HDRBT) boost between June 1996 and December 2005. Mean age was 57 years; 75% had invasive ductal carcinoma. The most frequent surgery was lumpectomy (55.7%); 39.4% were G3, 18.6% intraductal component >25% and only 22% had negative margins. RESULTS: With a mean follow-up of 85 months, at 5 and 10 years the OS was 93% and 88%, DFS 92% and 89%, and LR 3.6% and 5.3%, respectively. For LR, the risk factors were carcinoma in situ, N+ and involved margins, whereas for metastasis, the risk factors were T2 tumours, stage III, N+ and the presence of local recurrence. CONCLUSIONS: HDR-BT boost in one fraction is an effective, simple and safe method for reducing LR. The outpatient setting and shorter treatment duration represent undeniable advantages (AU)
Subject(s)
Humans , Male , Female , Breast Neoplasms/chemistry , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Breast Neoplasms/diagnosis , Breast Neoplasms/immunologyABSTRACT
A clinical case study of a 50 year-old woman brought to the Rhematology Department is presented, who showed clinical dry syndrome with immune disorders (not currently defined) and developed tumors (benign at present) and analytical autoimmunity with positive antitopoisomerase type I (formerly Scl70) confirmed. The clinical case is commented and the metheorism causes are discussed, among it, a possible variation of abdominal epilepsy as ictal flatulence, secondary to a meningioma of the right brain convexity.
Subject(s)
Epilepsies, Partial/complications , Flatulence/etiology , Meningeal Neoplasms/complications , Meningioma/complications , Rheumatic Diseases/complications , Electroencephalography , Epilepsies, Partial/therapy , Female , Flatulence/therapy , Humans , Meningeal Neoplasms/pathology , Meningeal Neoplasms/therapy , Meningioma/pathology , Meningioma/therapy , Middle Aged , Rheumatic Diseases/pathology , Rheumatic Diseases/therapy , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Se presenta el caso de una mujer de 50 años, remitida a la consulta de Reumatología para estudio de un síndrome seco clínico con una alteración inmunitaria (aún no definida), que desarrolla tumores (de momento benignos) y autoinmunidad analítica de tipo antitopoisomerasa 1 (anti Scl-70) confirmado. Se comenta el caso clínico y se discuten las causas de su meteorismo, entre ellas una posible variante de epilepsia abdominal como ventoseo comicial, secundario a un meningioma de la convexidad cerebral derecha (AU)
