ABSTRACT
PURPOSE: The purpose was to establish the impact on survival of early detection of a local recurrence of breast cancer as compared to late detection. DESIGN: A meta-analysis was carried out using Cochrane review manager software (RevMan version 4.2). Studies were included if women were treated for primary breast cancer without evidence of distant metastasis at primary diagnosis and if these concerned routine follow-up strategies focusing on the early detection of curable recurrences. Data regarding the risk for death were derived from each study. Multi level models were used to study heterogeneity by using MLWin. RESULTS: Thirteen studies concerning 2,263 patients were included. Early detection of breast cancer recurrences during follow-up gave a significantly better survival as compared to late detected recurrences (HR: 1.68 (95% CI: 1.48-1.91)). Survival was better when the recurrence was found by mammography instead of physical examination or in patients without symptoms as compared to those with symptoms (HR: 2.44 (95% CI: 1.78-3.35); HR: 1.56 (95% CI: 1.36-1.79), respectively). If all breast cancer recurrences would be detected earlier, that 5-8 deaths (i.e. an absolute reduction in mortality of 17-28%) would be avoided by performing routine follow-up during a 10 year-period for 1,000 breast cancer patients. CONCLUSION: These data support the hypothesis that detection of isolated loco-regional or contra-lateral breast cancer recurrences in patients without symptoms has beneficial impact on survival of breast cancer patients when compared to late symptomatic detection.
Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Breast Neoplasms/mortality , Female , Humans , Mammography/methods , Medical Oncology/methods , Middle Aged , Models, Statistical , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Recurrence , Treatment OutcomeABSTRACT
This paper reports on inpatient treatment of addicts. Attention is paid to the Therapeutic Community (TC) model employed with alcoholics. A sample of 881 patients was assessed at intake and was followed up. The results demonstrate that the patients improved on a variety of outcome measures. Some associations were found between patient variables and improvement. Treatment variables predicting a positive outcome were sustained treatment in a TC and attending AA meetings. The relative efficacy of TCs, originally created by drug users, holds for alcoholics as well. It is concluded that an important precondition to a positive treatment outcome is the continuity of the treatment process. Pursuing that continuity seems to be an excellent mediate goal for both addicts and treatment personnel.
Subject(s)
Residential Treatment/standards , Substance-Related Disorders/therapy , Therapeutic Community , Absenteeism , Adaptation, Psychological , Alcoholism/therapy , Factor Analysis, Statistical , Female , Follow-Up Studies , Humans , Male , Netherlands , Patient Dropouts , Regression Analysis , Residential Treatment/methods , Social Adjustment , Treatment OutcomeABSTRACT
We depict a method of determination of the size D depth z and temperature T0 + delta T of a cylindrical thermal structure embedded in an homogeneous glossy material, in the present case, water. A microwave radiometric image at 3 GHz points out the location of the thermal structure; its threshold provides the diameter D of the structure. The depth z derives from the ratio of the maximal radiometric intensities at 1.5 and 3 GHz. The combination of D,z and of the radiometric intensities gives delta T.
Subject(s)
Image Processing, Computer-Assisted , Microwaves , Thermometers , Body Temperature , Electronic Data Processing , Humans , Radiometry/methodsABSTRACT
Correlation microwave thermography, a new process based on a coherent detection of noise, is able to improve the localization of the thermal gradients in the tissues. We explain the principles of this method and describe the first system which has been built and tested. Several experiments point out that with this process better spatial resolution and flexibility can be expected.
