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Breast preservation has been shown to be a good alternative to mastectomy in selected patients with breast cancer. The purpose of this study was to evaluate the characteristics of cancer developing in the opposite breast to determine if breast preservation should be attempted in that breast as well. From 1979 to 1988, 172 women underwent tylectomy, axillary dissection and irradiation for carcinoma of the breast. All had follow-up mammogram. Mean age was 55 years. Mean follow-up time was 50 months. Thirteen patients (7.6%) developed cancer in the opposite breast. Three cancers were carcinoma in situ, nine were stage I, and one was stage IIa. Nine of 13 patients had breast preservation therapy, and four had mastectomies. Ten patients are alive with no evidence of disease, two are alive with disease and one died with disease. Breast preservation for bilateral breast cancer is a safe alternative if patients can be followed closely.

Although fine needle aspiration (FNA) of thyroid masses has been performed since the 1950s, only recently has it become a common method of diagnosing thyroid malignancy. To assess the trends in thyroid surgery during the last 38 years at this institution, a retrospective study of the total number of cases during 2-year periods of each decade were reviewed, yielding 509 cases. Results showed that the total number of cases and the type of surgical procedure remained stable until recent years when FNA was more commonly used. For the 1987-1988 period, the total number of cases decreased (from an average of 112 per period in 1950-1981 to 60 in 1987-1988), but the percentage of cases with carcinoma was markedly increased (from 6.3% in 1950-51 to 46.7% in 1987-88). The percentage of total thyroidectomies performed increased due to a preoperative pathological diagnosis afforded by FNA. A decrease in surgical complications was also seen (from an average of 4.5% per period in 1950-1981 to 1.6% in 1987-1988). FNA has been shown to reduce the number of patients requiring surgery, increase the percentage of carcinoma in operative cases, increase the number of total thyroidectomies, and increase the percentage of preoperative pathologic diagnoses.