ABSTRACT
BACKGROUND: South East Sweden with 976 000 inhabitants is served by nine hospitals with specialized breast surgeons. Population-based mammographic screening was introduced in 1986 for women aged 40-74 years. Patients with primary breast cancer were treated according to a joint management programme. METHODS: All patients were reported to a regional cancer registry from which breast cancer incidence, treatment and survival in this defined population were reported. RESULTS: A total of 7892 women had their first invasive breast cancer diagnosed between 1986 and 1999. The median tumour size was 17 mm and 29.9 per cent had axillary metastases. Some 49.8 per cent of these women had a modified radical mastectomy and 31.9 per cent had a segmental resection with axillary clearance. Postoperative radiotherapy was given to 40.3 per cent of the women after mastectomy and to 87.1 per cent after breast-conserving surgery. Tamoxifen and chemotherapy were used as adjuvant treatment except in low-risk patients. Breast cancer-specific survival rate for all stages was 83.5 per cent at 5 years and 74.0 per cent at 10 years. Respective values were 95.8 and 90.9 per cent for patients with stage T1 N0 M0 tumours, and 77.7 and 62.4 per cent for those with T1-2 N1 M0 tumours. CONCLUSION: Breast specialists treating women with breast cancer according to a joint management programme have achieved very good survival rates.
Subject(s)
Breast Neoplasms/mortality , Adult , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , Cohort Studies , England/epidemiology , Female , Humans , Lymphatic Metastasis , Middle Aged , Survival Analysis , Survival Rate , Treatment Outcome , Wales/epidemiologyABSTRACT
PURPOSE: To evaluate the efficacy of pamidronate 60 mg i.v. q 4 weeks in women with advanced breast cancer with skeletal metastases. PATIENTS AND METHODS: 404 woman with skeletal metastases from breast cancer in Sweden and Norway were included in a randomized, placebo-controlled, multicenter study. Except for the study medication, other palliative treatment was chosen at the discretion of the physician. Skeletal related events, i.e. increased pain, treatment of hypercalcemia, pathologic fractures of long bones or pelvis, paralyses due to vertebral compression, palliative radiotherapy for skeletal metastases, surgery on bone and change of antitumor therapy were recorded every third month as well as a self-estimated pain-score using visual Analog Scales and analgesic consumption. RESULTS: There was a significantly increased time to progression of pain (p < 0.01), to hypercalcemic events (p < 0.05) as well as for the cumulative number of skeletal related events (p < 0.01) in favor for the pamidronate group. No statistically significant reduction of pathologic fractures of long bones or pelvis, or pareses due to vertebral compression occurred. No statistically significant differences were found for the need of radiotherapy and surgery on bone. The pamidronate group faired better regarding performance status (p < 0.05). There was a statistically not significant lower consumption of opioid analgesics in the pamidronate group (p = 0.14). CONCLUSION: Pamidronate 60 mg i.v. q 4 weeks reduces skeletal events and improves the quality of life in women with bone metastases from breast cancer.
Subject(s)
Antineoplastic Agents/pharmacology , Bone Neoplasms/drug therapy , Bone Neoplasms/secondary , Breast Neoplasms/drug therapy , Diphosphonates/pharmacology , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Breast Neoplasms/pathology , Diphosphonates/administration & dosage , Diphosphonates/adverse effects , Double-Blind Method , Female , Humans , Infusions, Parenteral/adverse effects , Middle Aged , Pain/drug therapy , Pamidronate , Quality of Life , Time FactorsSubject(s)
Breast Neoplasms/drug therapy , Mitoxantrone/administration & dosage , Pleural Effusion, Malignant/drug therapy , Pleural Neoplasms/secondary , Aged , Breast Neoplasms/pathology , Breast Neoplasms/radiotherapy , Drainage/methods , Female , Humans , Palliative Care , Pleural Neoplasms/drug therapy , Quality of LifeABSTRACT
The management of cecal volvulus is controversial. From 1971 to 1986, 26 patients with cecal volvulus were treated at Malmö General Hospital. Treatment and patient follow-up are presented, together with a review of 350 patients reported in the literature during the past 15 years. Anatomic background and types of volvulus are described. Simple detorsion is an alternative in high-risk patients without gangrene, but resection is the method of choice also when there is no gangrene present.
Subject(s)
Cecal Diseases/surgery , Intestinal Obstruction/surgery , Cecal Diseases/pathology , Cecal Diseases/physiopathology , Female , Gangrene , Humans , Intestinal Obstruction/pathology , Intestinal Obstruction/physiopathology , MaleABSTRACT
General complications, wound complications and hospital stay after surgery for operable mammary carcinoma were studied prospectively in 385 patients treated by either modified radical mastectomy (324 operations) or segmental resection with axillary dissection (71 operations). The overall infection rate was 3.6 per cent. Postoperative seromas were noted in 34.8 per cent of the wounds. Other complications were few. The average hospital stay was 7.2 days. Seventeen per cent of the total number of days in hospital for these patients were due to factors other than the mammary cancer.
