Abstract Aim : Evaluate value ER, PR and HER2 status as independent prognostic factor of local recurrence after breast conserving surgery Methods and materials: The retrospective study of 537 breast cancer patients stage I,II,III which were combined treated in Institute Oncology, Vilnius University in 2005-2006.was made The surgery treatment was used as primarily selection criteria, the data on vital status of all patients was summarized by December, 2008. The median follow-up time was 33 month. Pts age was from 29 years to 76 years. Premenopausal pts (<50 years) - 181 pts, postmenopausal – 356 pts. All pts underwent Breast conserving surgery, irradiation and chemohormono therapy. Distribution of pts according pathological tumor size "pT" was pT0 - 5 pts (1,0%), pT1 - 312 pts (58,1%), pT2 - 208 pts (38,7%), pT3 - 12 pts (2,2%). Distribution of pts according to nodal status "pN" was: "N0" - 333 pts (62,1%), "N1"- 172 pts (32%), "N2" - 30 pts (5,8%), "N3" - 2 pts (0,3%). Distribution of pts according differentiation degree "G" was “G1"- 100 (18,6%), "G2"- 266 (49,7%), "G3" - 171 (31,7%). Pts distribution according ER receptors positive tumors was ER strong (score >=10) - 166 pts (30,9%), medium (score 6-9) - 146 pts (27,2%), week (scrore <=5) - 72 pts (13,4%), no reaction - 148 pts (27,6%). Pts distribution according PR receptors positive tumors was PR strong (score >=10) - 141 pts (26,6%), medium (score 6-9) - 125 pts (23,3%), week (scrore <=5) - 84 pts (15,6%), no reaction - 182 pts (33,9%). Pts distribution according HER2 receptors (3+) - 117 pts (21,8%), HER2 receptors (2+) - 116 pts (21,8%), HER2 receptors (1+) - 188 pts (35,0%), HER2 receptors no reaction - 110 pts (20,5%).Results: Local recurrence rate was calculated according Nelson-Aalen cumulative hazard estimate (analysis time 4 years) and was equal to 8 %.Local recurrence rate according ER-, PR-, HER2 0 vs ER+, PR+, HER2 3+ was equal to 14% vs 4,5%.In 63,5% of all local recurrence ER, PR were negative “0 “,in 40.9% of all local recurrences HER2 was positive (3+) Conclusion: According to our preliminary results ER, PR and HER2 status are independent prognostic factor of local recurrence after breast. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6047.
Objective:We have an insufficient scientific data about pre-Halstedian period of breast cancer (BC) history, and about the results of BC treatment.The aim of this article to present authentic scientific data about pre-Halstedian (1867 -1894) period of BC history, to introduce techniques and results of BC operations. Materials And Methods:This article based on the original papers of the European, and the American scientists of the end of XIX -beginning of the XX century In 1894, Cheyne, Halsted, and Meyer introduced radical mastectomy for the treatment of BC.Since the end of XIX century and to the second half of the XX century radical mastectomy become the gold standard for treatment of BC.In 1960s, Auchincloss, Madden presented technique of modified radical mastectomy (MRM).In 1972, Madden, introducing MRM wrote: "MRM is not a new technique and it was popular about century or more ago".In 1875, Volkmann introduced his technique for treating BC; he removed the breast, pectoral fascia, performed axillary nodes dissection.Results: During 25 years, 3-yeasr results of Volkmann operation were significantly improved from 17. 8 %-23 % in 1880/1881 to 35%-45 % in 1891/1900.According to presented data, in pre-Halstedian period, Volkmann operation, become the standard of BC treatment. Conclusions:The period of pre-Halstedian BC history (1867-1894), the results of Volkmann breast operation, the names of prominent European and American surgeons and scientists were forgotten, and our duty to reintroduce it.
Phyllodes tumors (PTs) are rare fibroepithelial neoplasms of the breasts. Approximately 10%-15% of PTs are malignant, and 9%-27% of patients with malignant PTs, develop metastatic disease. The lungs are the most common target organ for distant metastasis of PT. We report a case of 44-year-old female with a malignant PT. It had recurred locally 3 times, and 3 relapses occurred 13 months after the first diagnosis, presenting multiple metastases to the lungs by CT scan. The patient underwent radiation therapy, and palliative chemotherapy with doxorubicin was initiated. Two courses of doxorubicin therapy were administered, but the patient expired 16 months after PT diagnosis. We present a rare case of malignant PT with local recurrences, lung metastases, and poor patient outcome. Although malignant breast PTs have an unfavorable prognosis, adjuvant radiotherapy combined with margin-negative resection may be associated with decreased local recurrence and distant metastasis rates. Future research should include randomized clinical trials or well-designed prospective matched studies to clarify the effectiveness of treatments of PTs.
Background. The aim of this article is to present a rare clinical case of vasa praevia as well as to assess the relevance of the problem by reviewing the latest literature sources. Materials and methods. In this report we present a case of a 33-yearold woman diagnosed with vasa praevia at 33 weeks of pregnancy, after hospitalisation with preterm rupture of membranes following the delivery of a live healthy baby through a lower segment Caesarean section during 33rd week of gestation at Vilnius University Hospital Santariškių Clinics. We investigated all the documentation of the patient before and after delivery. Results and conclusions. Vasa praevia is a rather rare pathology which is likely to occur during pregnancy, may result in heavy bleeding and be particularly threatening to the fetus life. A timely diagnosis for these women is essential. The gold standard for vasa praevia diagnosis is the fetal ultrasound scan. Vasa praevia pathology is found during the routine second trimester ultrasound check-up. The selection of proper tactics applied during pregnancy care is essential. At the gestational age of 28–32, it is advisable to mature fetal lungs as well as the fetus condition should be investigated by a perinatologist. The mode of delivery is the C-section which tends to reduce the frequency of possible complications.
