Search

The authors report the results of a prospective study on 204 patients (1980-1993) affected by early infiltrating breast cancer (size pounds 2 cm) as a part of a surgical series of 608 cases. 53 cases who underwent QUART (25.9%) and 151 cases (74.1%) who underwent mastectomy modified according to Patey have been collected. 10 years actuarial survival has been respectively 79% after extensive surgery and 78% after conservative treatment. Local recurrences have been observed in 9 cases after meticulous follow-up (median 74.8 months, range 12-178): 3 (5.66%) patients after QUART and 6 (3.97%) after mastectomy; furthermore 1 patients after a conservative treatment (1.88%) has developed a second tumor at the same side probably dependent on the presence in the primary tumor of an extensive intraductal component. No correlations between histological features, grading, positive nodes, receptor status and local recurrences have been found. Only the age of patients looks significantly correlated with frequency of recurrences: 44.45% of local recurrences have been observed in patients less than 45 years old. Local recurrences after QUART have obliged, in all cases, to a radical mastectomy. Furthermore, frequency of distant metastases has been considered: after QUART percentage is lower (9.43%) than after radical mastectomy (13.9%). This consideration looks correlated with the longer follow-up of the later group. A multidisciplinary approach is advised but the most important role is played by surgery. In conclusion it is outlined that conservative surgery is addressed to selection and consenting patients.

Primary and sole breast lymphoma is a very rare disease. With the review of our series of 616 cases operated on for breast cancer, only 3 cases (0.48%) of primary breast non-Hodgkin lymphoma (LNH) have been observed. The authors outline the problems concerning diagnosis and therapy of this rare disease: pathological and immunohistochemical aspects are discussed. They stress the importance of staging in order to plan a correct multidisciplinary approach.

Aim of the study is to evaluate the biology, the clinical evolution and the prognosis of lobular carcinoma of the breast. We retrospectively evaluated the patients treated in our institution during the last 13 years. 117 patients with lobular carcinoma of the breast and 117 patients, randomized out of 397 patients with 'classical' pattern of ductal carcinoma were compared. Age distribution, type of surgery, tumor size, TNM stage, axillary lymph node involvement, multifocality, multiple breast cancers, local and distant recurrences, overall survival and disease-free survival have been evaluated. There was not a significant difference in tumor size, lymph node involvement, stage distribution, estrogens and progesterone receptors status, local and distant recurrences. The only significant differences were found in multifocality and multiple breast cancers. The said difference does not seem to modify the overall survival and the disease-free survival that are the same in the two groups. Our research shows that tumor size and axillary lymph node status are the only elements that have to be considered in the choice of the surgical treatment and prognosis. It seems that the difference in distant metastatic pattern between lobular and ductal carcinoma is the distinctive feature in the follow-up of these patients.