Immunological investigation and immunotherapy in patients operated on for breast carcinoma.

The tumor-host relationship is an essential factor in the onset, development, and recovery from malignancies. A basic consideration in the treatment of cancer patients must therefore be to understand this relationship and attempt to modify it in order to favor the host. We here discuss the results of a study of the immunologic status of 91 breast cancer patients. The use of a battery of tests with five subcutaneous hypersensitivity antigens allowed us to detect some differences in the immunological profiles of patients with or without lymph node involvement. The effect of an immunostimulant fraction prepared from Corynebacterium granulosum, P40 is also analyzed. This fraction significantly modifies tumoral recurrence in DMBA-induced mammary cancers in the Sprague Dawley rat, causes regression of mammary permeation nodules following in situ injection and modifies the cutaneous reactions of one-half of the anergic breast cancer patients although regular re-challenge is still necessary.

[Breast cancer: a dynamic approach of cellular immunity and immunostimulation with an immunoadjuvant: P40 fraction. (author's transl)]. / Cancer du sein opérable. Appréciation dynamique de l'immunité cellulaire et de l'immuno-stimulation par l'adjuvant P40.

The study of the immune status of breast cancer patients with delayed hypersensitivity skin tests reveals a clear immune deficiency in comparison with a reference patients group. This immunstatus was significantly improved by an immunstimulation with the P40 fraction. The responsive capacity to an immunstimulation appears independant of the lymphnodes involvment, whereas, on the contrary, the initial degree of immune deficiency appears connected. The P40 fraction has an immunstimulant effect comparable with the BCG and has not occasioned any local or general undesirable reaction.

[Thyroid carcinoma. Indications and results of treatment (author's transl)]. / Cancers thyroïdiens. Indications et résultats thérapeutiques.

Frozen section histological study of all cold nodules requiring total extracapsular lobectomy is absolutely essential during surgery. Whilst total thyroidectomy for intracapsular carcinomas is most often proposed in extracapsular carcinomas, the authors deliberately leave a small part of the gland in contact with the parathyroids. The need for recurrent laryngeal lymph node dissection is accepted, as is the principle of jugulo-carotid dissection.