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Infiltrating MBC represents less than 1% of all male cancers. Our study details clinico-pathological features, treatments and prognostic factors in a large French cohort.Four hundred and eighty-nine patients were collected from 1990 to 2005. Median age was 66 years (34% over 70 years) and median follow-up 58 months.According to TN classification, we found T(1): 39%, T(2): 41%, T(3)T(4): 9%, T(x): 11% and N(1)N(2): 27%. Lumpectomy (L) and mastectomy (M) were performed in 8.6% and 91.4% of the cases. Axillary dissection (AD), sentinel node biopsy or both were performed in 90%, 2% and 5% of the cases, respectively. Ninety-five percent of tumours were ductal carcinomas; 47% were pT(1), 20% pT(2) and 33% pT(3)-T(4). Axillary nodal involvement was present in 52.8% cases. ER and PgR were positive in 92% and 89% cases. Radiotherapy (RT) was performed in 85% of the patients. Hormonal treatment (HT) was delivered in 72% of the cases. Tamoxifen and aromatase inhibitors were used in 85% and 12% of the cases; 34% of the patients received chemotherapy (CT). Local recurrence (LR), nodal recurrences (NR) and metastases occurred in 2%, 5% and 22% of the cases; 2% and 10% developed contralateral BC and second cancer. The 5- and 10-year overall survival (OS) rates were 81% and 59%; disease-specific survivals (DSS) were 89% and 72%. Death causes were BC 56%, second cancer 8%, complications 3%, intercurrent disease 15% and unknown 18%. In a univariate analysis, metastatic risk factors were T stage (T1: 19%, T(2): 26%, T(3)T(4): 40%; p=0.013), pN status (pN(0): 12% pN(1-3): 26% pN(3): 44%; p0.0001) and presence of locoregional recurrence (62% versus 18% p0.0001). In a multivariate analysis, axillary nodal involvement and high SBR remain prognostic factors.Earlier diagnosis and wide use of adjuvant treatments (RT/HT/CT) widely decreased LR and increased survival rates in MBC, reaching female ones. Prognostic factors were also very similar to female ones.

Resume Objectif Cette etude analyse les resultats de la « pratique clinique courante » chez 882 patientes traitees pour un carcinome canalaire in situ (CCIS) pur du sein dans 9 centres de lutte contre le cancer francais entre 1985 et 1995. Methode L’âge median etait de 53 ans ; 177 patientes (20 %) ont eu une mastectomie (M), 190 (22 %) une chirurgie conservatrice seule (CS) et 515 (58 %) une CS avec radiotherapie (CS + RT). Resultats Avec un recul median de 7 ans, les taux de recidive locale (RL) etaient de 2 %, 31 % et 13 % dans les groupes M, CS et CS + RT (p 60 ans (non significatif). Dans le groupe CS + RT, ces taux passent a 33 %, 13 % et 8 % (p Conclusion La mastectomie reste le traitement le plus sur des CCIS, assurant un controle local a 7 ans de 98 %. Dans notre etude, apres CS, la RT diminue tres significativement les taux de RL, avec des chiffres comparables a ceux des essais randomises NSABP B-17 et EORTC 10853. Le benefice de la RT est trouve dans tous les sous-groupes, quels que soient les facteurs cliniques ou histologiques consideres, mais son importance est variable. L’âge inferieur a 40 ans et l’exerese incomplete restent les deux facteurs majeurs de RL.

Resume Objectif Cette etude analyse les resultats de la « pratique clinique courante » chez 882 patientes traitees pour un carcinome canalaire in situ (CCIS) pur du sein dans 9 centres de lutte contre le cancer francais entre 1985 et 1995. Methode L’âge median etait de 53 ans ; 177 patientes (20 %) ont eu une mastectomie (M), 190 (22 %) une chirurgie conservatrice seule (CS) et 515 (58 %) une CS avec radiotherapie (CS + RT). Resultats Avec un recul median de 7 ans, les taux de recidive locale (RL) etaient de 2 %, 31 % et 13 % dans les groupes M, CS et CS + RT (p 60 ans (non significatif). Dans le groupe CS + RT, ces taux passent a 33 %, 13 % et 8 % (p Conclusion La mastectomie reste le traitement le plus sur des CCIS, assurant un controle local a 7 ans de 98 %. Dans notre etude, apres CS, la RT diminue tres significativement les taux de RL, avec des chiffres comparables a ceux des essais randomises NSABP B-17 et EORTC 10853. Le benefice de la RT est trouve dans tous les sous-groupes, quels que soient les facteurs cliniques ou histologiques consideres, mais son importance est variable. L’âge inferieur a 40 ans et l’exerese incomplete restent les deux facteurs majeurs de RL.

Resume Objectif de l'etude Le cancer du sein est le cancer le plus frequent chez la femme. Son incidence croit avec l'âge. La proportion de cancers du sein apres 70 ans est actuellement estimee a 34 % en Europe. L'objectif de cette etude retrospective est d'analyser les caracteristiques lesionnelles et les resultats therapeutiques dans une population feminine âgee d'au moins 70 ans traitee dans un meme centre au cours d'une periode de 15 ans. Patients et methodes De 1978 a 1992, 1 143 femmes âgees de 70 ans et plus ont ete traitees pour un cancer du sein unilateral non metastatique et suivies avec un recul moyen proche de 6 ans. Le traitement initial a ete chirurgical chez 1 012 patientes, consistant en une mastectomie radicale dans 95 % des cas avec curage axillaire dans 97,6 %. Une radiotherapie adjuvante a ete realisee chez 289 malades et un traitement adjuvant par tamoxifene chez 411 malades. Les resultats ont ete compares a ceux obtenus chez 2 947 patientes âgees de 50 a 69 ans traitees durant la meme periode dans le meme centre. Resultats La survie corrigee a 5 ans chez les femmes de plus de 70 ans a ete de 80 % contre 85,5 % chez les femmes de 50 a 69 ans (p Conclusions Dans cette serie, le traitement a ete centre sur le traitement chirurgical classique complete par la radio therapie adjuvante en fonction de l'envahissement ganglionnaire et par l'hormonotherapie adjuvante en fonction surtout des recepteurs hormonaux. Cependant, les traitements adjuvants n'ont pas pu etre appliques dans tous les cas. Le taux de survie a 5 ans inferieur a celui des patientes plus jeunes pourrait etre attribue au caractere incomplet de ces traitements adjuvants. Des essais controles specifiques prenant en compte la qualite de vie sont necessaires pour adapter le traitement en fonction de l'âge des malades et de leur etat physiologique.

Purpose Ductal carcinoma in situ overall prognosis is excellent, but after breast conserving surgery, with or without radiotherapy, local recurrences can lead to locoregional or distant evolution and death. However, there are few data on optimal local recurrences treatment and long-term impact on survival. Patients and methods This study included 195 women treated from 1985 to 1996 by conservative surgery (CS) or conservative surgery followed by radiotherapy (CS + RT), presenting local recurrences, with a 156-month median follow-up. Results Eighty-two out of 195 (42%) local recurrences were non-invasive (in situ) and 113 (58%) invasive. In situ local recurrence was discovered by mammography in 80.5% of the cases versus 47.5% for invasive local recurrence (P = 0.0001). Salvage mastectomy was used in 53% of the cases after conservative surgery and 75% after conservative surgery followed by radiotherapy. The axillary nodal involvement rates were 11.8% and 25.8% among 17 and 62 patients with in situ and invasive local recurrences. Among 113 patients with invasive local recurrences and 82 with in situ local recurrences, 19 (16.8%) and three (3.6%) developed metastases, respectively. Among invasive local recurrences, comedocarcinoma subtype was highly predictive of subsequent metastases (32% versus 4.4%, P Conclusion Invasive local recurrence after ductal carcinoma in situ treatment could be a dramatic event, fully changing long-term prognosis. Early mammographic local recurrence diagnosis (if possible still at non-invasive stage) seems essential to avoid or minimize metastatic risk. Mastectomy remains the safest option but, in some cases, a new conservative approach could be discussed.

Background After breast conservative treatment (BCT), young age is a predictive factor for recurrence in patients with Ductal Carcinoma In Situ (DCIS) of the breast. The purpose of this study was to evaluate predictive factors for recurrence and outcomes in these younger women (under 40 years) treated for pure DCIS. Methods From 1974 to 2003, 207 cases were collected in 12 French Cancer Centers. Median age was 36.3 years and median follow-up 160 months. Seventy four (35.8%) underwent mastectomy, 67 (32.4%) lumpectomy alone and 66 (31.9%) lumpectomy plus radiotherapy. Results 37 recurrences occurred (17.8%): 14 (38%) were in situ and 23 (62%) invasive. After BCT, the overall rate of recurrence was 27% (33% in the lumpectomy plus radiotherapy group vs. 21% in the lumpectomy alone group). Comedocarcinoma subtype ( p = 0.004), histological size more than 10 mm ( p = 0.011), necrosis ( p = 0.022) and positive margin status ( p = 0.019) were statistically significant predictive factors for recurrence. The actuarial 15-year rates of local recurrence were 29%, 42% and 37% in the lumpectomy alone, lumpectomy and whole breast radiotherapy and lumpectomy + whole breast radiotherapy with additional boost groups respectively. After recurrence, the 10-year overall survival rate was 67.2%. Conclusion High recurrence rates (mainly invasive) after BCT in young women with DCIS are confirmed. BCT in this subgroup of patients is possible if clear and large margins are obtained, tumor size is under 11 mm and necrosis- and/or comedocarcinoma-free.

This study assesses the results of "current clinical practice" among 882 women treated in nine French Cancer Centers from 1985 to 1995 for pure ductal carcinoma in situ (DCIS) of the breast.Median age was 53 years (range 21-87); 177 (20%) patients underwent mastectomy (M), 190 (22%) conservative surgery alone (CS) and 515 (58%) conservative surgery with radiotherapy (CS + RT).The crude 7-year local relapse (LR) rates were 2%, 31% and 13% among the M, CS and CS+RT subgroups (p0.0001). All four LR after M were invasive as well as 31 (52%) out of 59 and 40 (61%) out of 66 in the CS and CS+RT groups. Distant metastases occurred in 1%, 3% and 1% of the three treatment groups. No LR factors were found in the M group. Among women treated with CS, the 7-year LR rates were 36%, 31% and 30% among women aged 40 or less, 41 to 60 and 61 or more (NS). For women treated by CS+RT, the LR rates in these age subgroups were 33%, 13% and 8%, respectively (p0.0001). Patients with negative, positive or uncertain margins had 7-year LR rates of 26%, 56% and 29% respectively if treated with CS (p=0.02) and 11%, 23% and 9% if treated with CS+RT (p=0.0008). RT reduced LR rates by 65% in all histological subgroups, but more particularly in comedocarcinoma and mixed cribriform/papillary subgroups. The 7-year rate of contralateral breast cancer was 7%, identical in all subgroups.Mastectomy remains the safest treatment for women with DCIS, with a 98% 7-year control rate. After conservative surgery, RT reduces very significantly LR rates, according to the NSABP B-17 and EORTC 10853 randomized trial results. The RT benefit is present in all clinical/histological subgroups, but its magnitude varies. Young age (40 years) and incomplete excision are the most important LR risk factors.

Until now, less than 5% of the patients with breast ductal carcinoma in situ (DCIS) have been enrolled in clinical trials. Consequently, we have analysed the results of ‘current practice’ among 716 women treated in eight French Cancer Centres from 1985 to 1992: 441 cases (61.6%) corresponded to impalpable lesions, 92 had a clinical size of less than or equal to 2 cm and 70 from 2 to 5 cm; in 113 cases, the size was unspecified. Median age was 53.2 years (range: 21–87 years). 145 patients underwent mastectomy (RS) and 571 conservative surgery (CS) without (136) or with (435) radiotherapy (CS+RT). The mean histological tumour sizes in these three groups were 25.6, 8.2, 14.8 mm, respectively (P

The purpose was to evaluate the usefulness of serum Cyfra 21.1 assay for the monitoring of patients with uterine cervix cancer.Pre-treatment sera and complete follow-up of the patients were available for SCC and Cyfra 21.1 for 79 patients Another group of 50 patients was studied to evaluate the specificity, sensitivity, negative or positive predictive values of the markers. The cut-off value for Cyfra 21.1 (1.1 ng/ml) was established by ROC curve analysis.A positive or negative concordance between SCC and Cyfra 21.1 was observed in 65.8% of the cases. Positive SCC and negative Cyfra 21.1 were found in 22.8% of the sera, while the inverse was observed in 11.4% of the cases. The mean concentrations of SCC and Cyfra 21.1 were correlated to FIGO stages, with Cyfra 21.1 being elevated in 100% of stages III and IV. Cyfra 21.1 was also correlated with the extension of the cancer, and to the presence of metastases. The mean concentrations of both markers were significantly higher in the sera of patients with constant progression (Por = 0.0019). Analysis of 186 results from 91 patients followed-up with a median of 3.29 years showed a sensitivity of 89.5% for Cyfra 21.1, 75.0% for SCC, and a specificity of 86.4% and 99.1%, respectively. The positive predictive values were 91.9% for Cyfra 21.1 and 98.3% for SCC, and the negative predictive values 92.7% and 85.2%, respectively. Median lead times, calculated from the records of 18 selected patients with complete resection of the tumour, were found to be 60 days for Cyfra 21.1 and 50 days for SCC (P0.05).In cervical cancer Cyfra 21.1 is very well-correlated to the tumour burden and the extent of the disease. In the case of recurrence, this marker rises more often than SCC. We therefore propose the use of Cyfra 21.1 for the monitoring of cervical cancer.