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Background. Because of the relative rarity of breast cancer in males, data have not been sufficient to support a definitive analysis of pertinent prognostic factors. Remarkably, no studies of male patients with breast cancer have presented survival information based on the number of histologically positive axillary nodes, the most sensitive single indicator of prognosis in women with breast cancer. Methods. In this study, the clinical course of breast cancer was documented for 335 male patients registered from 1965 through 1986. For patients to be eligible, diagnoses had to be made within 3 months of registration and the patients had to have histologic confirmation and receive part or all of their initial treatment at 1 of 11 cancer centers participating in the International Patient Data Exchange System. Results. The survival rate at 10 years was 84% for patients with histologically negative nodes, 44% for those with one to three positive nodes, and 14% for the group with four or more histologically positive nodes. The survival rates at 5 years were 90%, 73%, and 55%, respectively. In a multivariable analysis, the risk of death due to breast cancer for a patient with four or more histologically positive nodes was 6.75 times that of a patient with negative nodes. Conclusions. The findings of the authors indicate the following: (1) The number of histologically positive axillary nodes and, to a lesser degree, tumor diameter are significant prognostic factors for breast cancer in male patients. (2) The prognosis of breast cancer is the same in male and female patients when compared on the basis of the number of histologically positive nodes. Cancer 1993; 71:154-61.

Breast cancer patients whose cancer has not spread to the lymph nodes of the armpit (axillary nodes) have the best prognosis for this disease. However, the current trend is to treat most of these patients with adjuvant chemotherapy in addition to the surgical removal of the cancer to destroy any microscopically small deposits of cancer cells that might have spread. It would be advantageous, however, to identify women for whom such adjuvant treatment provides no additional benefit. These patients could then be spared both the adverse side effects and the cost and inconvenience of chemotherapy. A study was conducted of 408 breast cancer patients with negative axillary lymph nodes; none of the patients received adjuvant chemotherapy. Nevertheless, four groups of patients could be identified who had seven-year disease-free rates better than 94 percent. These patients constituted one-third of the original breast cancer patients and may be a group who might be spared the risks of adjuvant chemotherapy in clinical practice. The first group consisted of patients with tumors of less than one centimeter which appeared well or moderately differentiated under the microscope. (To the pathologist, a 'differentiated' cancer cell retains many of the characteristics of the normal cells from which it arose.) In the present study, 48 patients fit into this group and all 48 were disease-free at seven years. The second group consisted of 35 patients older than 50 years with poorly differentiated cancers that were still less than one centimeter in size. These patients had a disease-free rate of 97 percent at seven years. The third group consisted of patients older than 50 with cancers between 1.1 and 2.0 centimeters that were well or moderately differentiated. The seven-year disease-free survival was 94 percent for this group. The last group consisted of patients with a specific form of breast cancer called ductal carcinoma in situ with microscopic invasion. The disease-free survival of this group was 100 percent after seven years. The best form of treatment for patients with small breast cancers (less than two centimeters) who do not fall into one of these low-risk groups is not yet certain, but the identification of additional prognostic factors may prove useful. (Consumer Summary produced by Reliance Medical Information, Inc.)

Adjuvant therapy is often recommended for patients with breast cancer whose disease has not spread to the lymph nodes. The rationale for adding this adjuvant chemotherapy is that 15 to 20 percent of such patients having surgical treatment alone will relapse within 10 years. However, these figures represent the total for all the various forms of node-negative breast cancer; adjuvant chemotherapy may be more appropriate for some types of breast cancer than others. Since the advent of mammography, there has been an increase in the detection of ductal carcinoma in situ (DCIS), a type of breast cancer in which cancerous cells are found in their place of origin and have not begun to spread even to the adjacent tissues. In ductal carcinoma in situ with microinvasion (DCISM) there is only limited spread beginning at the edges of the cancer. In a series of 498 breast cancer patients with negative (cancer-free) axillary lymph nodes, 36 were found to have DCISM. In over half the patients, the cancer was not detectable by any means except mammography. All 36 patients received surgical treatment only; 33 had radical mastectomy and 3 had wide excision with removal of the lymph nodes of the armpit. One patient died of a heart attack, and autopsy revealed no signs of breast cancer. The remaining 35 patients are alive without evidence of disease at a median follow-up of 57 months. The disease-free survival rate seems to be 100 percent for this group of patients, which indicates that adjuvant chemotherapy would provide no additional benefit over surgery for patients with DCISM. DCISM was originally considered to be a rare condition, but with the increasing use of mammography greater numbers of patients with DCISM will be diagnosed. In the present study, 8.8 percent of the patients with node-negative breast cancer had DCISM, indicating that the condition is now far from rare. (Consumer Summary produced by Reliance Medical Information, Inc.)

The article offers tips to Macintosh computer users including changing Voice Memo titles, managing videos on Safari operating system (OS), and activating AirPlay television broadcasting software.

This study was undertaken to investigate the diagnostic, therapeutic, and prognostic features of squamous cell carcinoma of the hug. The overall five-year survival rate for 734 patients was 5 percent, with a median survival of 5.9 months. Surgical excision for early-stage disease was particularly effective therapy. In 151 of 201 patients having surgical excision, the resections were deemed curative. Other modes of therapy proved ineffective, although a combination of radiation and chemotherapy provided cure in one of 39 patients; that patient is alive today after 11 years and three months.

A total of 1,615 patients with a confirmed diagnosis of lung cancer were treated at Roswell Park Memorial Institute between 1963 and 1974. Particular emphasis was given in this review to the 295 patients that underwent surgical resection of their primary lung lesion. Factors such as histology, type of resection, sex, age, staging, and degree of dissemination were considered possible influences on survival. The risks and benefits of intentional reductive or palliative surgery are considered along with the risk related to thoracotomies performed for diagnostic purposes.

Presents several letters to the editor on issues related to Association for Computing Machinery. Comment on the use of a caricature on the cover of the March 1984 issue of the journal; Discussion on the comments of David Brandin on the motion picture "WarGames"; Dangers to individual freedom inherent in the widespread use of the information technologies in reference to the letter by Brandin.