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One-hundred and two women had axillary lymphadenectomy for breast cancer and were randomised to early discharge with axillary drain in situ on the third postoperative day or standard duration 7 day hospital stay. The two groups did not differ with respect to seroma formation, wound infection or psychological profile as measured by the Hospital Anxiety and Depression Scale and Spielberger State Trait and Anxiety Inventory. Patient satisfaction levels were high in the early discharge group. The results confirm that early discharge after axillary lymphadenectomy is safe, practicable and satisfactory for patients. Such a policy offers considerable resource savings.

The serum levels of CA 195 were determined in 52 patients with histologically proven pancreatic carcinoma and compared with carcino-embryonic antigen (CEA), serum bilirubin and albumin. CA 195 levels were raised above the upper limit of 20 U/ml in 42 cases, giving a sensitivity of 80% for the detection of pancreatic carcinoma, whereas CEA was raised in only 55%. The levels of CA 195 and CEA were significantly higher in patients with metastatic disease, but potentially curable cases were not discriminated. Bilirubin and albumin levels were not significantly related to either the presence of metastases or the levels of the tumour markers. At the time of initial presentation, levels of both tumour markers correlated with the eventual duration of survival, but bilirubin and albumin did not. Significant increases in CEA and CA 195 were found in sequential blood samples, as the disease progressed. Neither CA 195 nor CEA was of sufficient sensitivity to be of value for screening, but both give an indication of the presence of metastases and of the subsequent duration of survival. CA 195 appeared to be more sensitive and might help to assess progress of the disease.

The effects of two different axillary techniques, i.e. sampling and dissection, in combination with mastectomy for operable carcinoma are compared. The dissection technique when combined with radiotherapy gives better local disease control than sampling. This also confirms the proposition that an axillary sampling technique is an inefficient method of staging breast cancer and its use will result in inferior local disease control.