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The biological behavior of breast cancer supports the impression that it is often a systemic disease which can recur many years after the treatment of the local lesion. Since 35% of patients without axillary nodal metastasis will have recurrence of the disease after mastectomy, prognostic indicators are necessary to identify the high-risk patients to allow a more rational adjuvant therapy. We studied the prognostic value of fatty tissue invasion, perineural involvement and lymphatic and venous peritumoral embolization in T2NOMO primary breast carcinomas. Fifty-three patients were studied after initial treatment (only Halsted mastectomy). They were divided into two groups: A (control), with 25 patients with 15 years of survival without clinical and laboratory evidence of metastasis, and group B, with 28 patients who developed metastasis after initial treatment. The results were analysed by the chi-square test (p < 0.05). The fatty tissue invasion was identified in 56.0% and 78.5% in the A and B groups respectively, while venous embolization was only detected in 8.0% of the group A tumors and in 10.7% of those in group B. Neither showed significant variation when analyzed according to the chi-square test. Lymphatic embolization and perineural involvement were found respectively in 36.0% and 40.0% in the group A tumors and in 67.8% and 71.4% of those in group B, exhibiting a significant statistical variation. When analysing the histopathological characteristics in the pre- and post-menopausal patients, the chi-square test disclosed that lymphatic embolization and perineural involvement had a significantly higher incidence only in premenopausal patients in group B.

The authors present two cases of transabdominal cervicouterine cerclage using Benson and Durfee's technique. In both cases the surgery was successful and the patients gave birth at 37 and 40 weeks, respectively, to healthy newborns. The technique is recommended by the authors since technical details are observed.

The authors report six cases of myasthenia gravis during pregnancy. Three patients experienced increasing severity of their disease and one death occurred in the puerperium. The infants were born with no evidence of neonatal myasthenia. The patients should be closely monitored during labor and puerperium. This disease is characterized by unpredictable exacerbations, and the association of myasthenia gravis and pregnancy increases the risk for the patient.