Abstract:
:Although survival from primary breast cancer has improved with earlier diagnosis and treatment, the management of the opposite breast is still in question. The risk factors for bilaterality are known, and preoperative mammography is occasionally helpful, but identification of early second breast cancer is very limited. Contralateral biopsy may provide a reasonable answer to the problem. During a 5-year period, 62 elective contralateral biopsies were performed in patients having mastectomies for primary breast cancer. This consisted of either a mirror image biopsy or, more commonly, a biopsy of the upper outer quadrant. Thirteen patients had simultaneous contralateral cancers, of whom two had clinically overt bilateral cancers and 11 (18%) had clinically occult malignancy. Seven of these 11 had both radiologically and clinically normal breasts. Thus, 11.3% had radiologically and clinically occult cancer demonstrated by biopsy. Surgical management consisted of total mastectomy with low axillary dissection for noninvasive cancers and modified radical mastectomy for invasive cancers. Pathologic findings of the dominant breast cancer and the contralateral lesion were: bilateral, noninvasive: three patients; invasive, noninvasive: (seven patients), and invasive, invasive: three patients. Although follow-up is short (median of 40 months), 82% of the patients who had clinically occult second-breast cancer remain free of disease. During a previous 8-year period, 37 of 500 primary breast cancer patients (7.4%) developed metachronous (33) or synchronous (4) second-breast primary cancers primarily diagnosed clinically or radiologically. Of these, 35 were invasive and two noninvasive cancers; 41% had nodal metastases. A selected "favorable group," 28 of these patients who were free of disease 3 years after their first cancer, was analyzed. The analysis showed that only 10 (36%) were surviving free of disease at 7 years; 25% were free of disease at 10 years. Although the incidence of clinically-recognized, second-primary breast cancer is relatively low, development of a second invasive cancer severely impairs patient survival. Contralateral biopsy would appear useful to identify patients with early invasive or preinvasive cancer in the second breast, which appears normal after clinical observation or mammography. It provides opportunity to reduce the risk of invasive cancer in that breast, as well as to provide important diagnostic and prognostic information.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Wanebo HJ,Senofsky GM,Fechner RE,Kaiser D,Lynn S,Paradies Jdoi
10.1097/00000658-198506000-00001subject
Has Abstractpub_date
1985-06-01 00:00:00pages
667-77issue
6eissn
0003-4932issn
1528-1140journal_volume
201pub_type
杂志文章abstract:OBJECTIVE:This study determined the association between proximal gastrointestinal (GI) colonization and the development of intensive care unit (ICU)-acquired infection and multiple organ failure (MOF) in a population of critically ill surgical patients. SUMMARY BACKGROUND DATA:ICU-acquired infection in association wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199308000-00001
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:To analyze the long-term results of distal pancreatectomy with en bloc celiac axis resection (DP-CAR), a newly designed extended surgical procedure for locally advanced cancer of the pancreatic body. SUMMARY BACKGROUND DATA:Pancreatic body cancer often involves the common hepatic artery and/or the celiac axi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000258608.52615.5a
更新日期:2007-07-01 00:00:00
abstract::During the 5-year period from January 1978 through December 1982, 196 patients with blunt trauma to the small bowel, colon, or mesentery were treated at the Maryland Institute for Emergency Medical Services Systems (MIEMSS) Shock Trauma Center. More than 80% of these patients were the victims of motor vehicle accident...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198502000-00011
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to investigate the effect of pylorus resection on postoperative delayed gastric emptying (DGE) after partial pancreatoduodenectomy (PD). BACKGROUND:PD is the standard treatment for tumors of the pancreatic head. Preservation of the pylorus has been widely accepted as standard proce...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002480
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To review retrospectively a 4-year experience with pediatric surgical networking at a major academic medical center in the Midwest. BACKGROUND:The growth of managed care in the United States during the past decade has had a major impact on the practice of medicine in general, but especially on academic medic...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199909000-00006
更新日期:1999-09-01 00:00:00
abstract::Survival after distal splenorenal shunt in appreciably better in nonalcoholic patients than in alcoholics. This increase in survival does not appear to be dependent upon the state of biochemical liver function or the severity of changes in liver histology since these latter were similar for both groups. We suggest tha...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197805000-00008
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to identify a set of microRNAs (miRNAs) as prognostic molecular biomarkers for the progression of Barrett esophagus (BE) to esophageal adenocarcinoma (EAC) to rationalize the surveillance programs in patients with BE. BACKGROUND:Histological dysplasia is currently used as the main bi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31826ddba6
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To determine the role of the microvascular endothelium in the regulation of regenerating liver mass after partial hepatectomy. SUMMARY BACKGROUND DATA:Angiogenesis is critical for both pathologic and physiologic processes. The ability of certain tissues, such as the liver, kidney, and spleen, to regenerate a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000059986.96051.EA
更新日期:2003-04-01 00:00:00
abstract::External pneumatic calf compression is effective but imperfect for antithrombotic prophylaxis in surgical patients. In preliminary studies, sequential filling of multisegmented leggings with graded pressure decreasing from ankle to knee increased venous flow velocity and wall shear stress, decreased residual venous vo...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198711000-00014
更新日期:1987-11-01 00:00:00
abstract::Obesity hypoventilation syndrome (OHS), defined as a PaO2 less than or equal to 55 mmHg and/or PaCo2 greater than or equal to 47 mmHg, was found in approximately 8% of morbidly obese patients undergoing gastric surgery for morbid obesity and was frequently associated with clinically significant pulmonary hypertension ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198805000-00015
更新日期:1988-05-01 00:00:00
abstract:INTRODUCTION:The use of extended criteria donors (ECDs) could minimize shortage of suitable donor livers for transplantation. In 3 years, the aggressive use of ECD livers has reduced the wait list at our center from 257 to 30 patients with a median wait time of 18 days without using living donors. This study compares t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000234896.18207.fa
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the psychosocial outcomes and body image of patients 2 years postmastectomy reconstruction using a multicenter, multisurgeon approach. BACKGROUND:Although breast reconstruction has been shown to confer significant psychosocial benefits in breast cancer patients at year 1 postreconst...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3181728a5c
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To determine whether an intervention with smoking cessation starting 4 weeks before general and orthopedic surgery would reduce the frequency of postoperative complications. SUMMARY BACKGROUND DATA:Complications are a major concern after elective surgery and smokers have an increased risk. There is insuffici...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0b013e3181889d0d
更新日期:2008-11-01 00:00:00
abstract::A cross-over design study was used to examine the metabolic consequences of enteral feeding for 48 to 96 hours with either a branched-chain amino acid (BCAA)-enriched (44% BCAA) or a conventional egg protein formulation in 12 severely burned adult patients. A stable isotope labeled leucine (L-1-13C-leucine) tracer app...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198804000-00009
更新日期:1988-04-01 00:00:00
abstract::Descriptions of the fasciae of the lower half of the face and of the adjacent cervical fasciae have long been puzzling and descriptively much too complex. For this reason, medical students, young medical and dental practitioners, and at times even senior surgeons frequently do not understand the anatomy of the cervico...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198612000-00015
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVE:To determine whether imputed data can be used to produce unbiased hospital quality measures. BACKGROUND:Different methods for handling missing data may influence which hospitals are designated as quality outliers. METHODS:Monte-Carlo simulation study based on 63,020 patients with no missing data in 68 hospi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31818e544b
更新日期:2009-01-01 00:00:00
abstract::Sixty patients with chronic alcohol-induced pancreatitis with endoscopic retrograde cholangiopancreatography evidence of common bile duct stenosis were studied to determine the clinical spectrum and natural history of this complication, as well as the indications for biliary bypass. In 17% of patients, common bile duc...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198911000-00007
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:Surgery for pediatric idiopathic constipation (IC) is undertaken after failure of bowel management programs. Decisions are influenced by rectal biopsy, transit studies, megacolon/megarectum, degree of soiling/incontinence, and anorectal manometry profile(s). A systematic review of ALL published studies critic...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000001191
更新日期:2015-12-01 00:00:00
abstract::A new system for long-term, 24-hour, ambulatory dual gastroduodenal pH monitoring is described. Eighteen patients with active duodenal ulcers and ten healthy subjects were studied. Simultaneous gastric and duodenal bulb pH were measured during fasting, the ingestion of a solid meal, and for the remainder of the 24-hou...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198812000-00005
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:To assess ischemia and reperfusion (I/R) injury in a hemihepatectomy model in pigs after prolonged continuous or intermittent vascular inflow occlusion in the liver. SUMMARY BACKGROUND DATA:Massive intraoperative blood loss during liver resections can be prevented by temporary vascular inflow occlusion, cons...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199903000-00011
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Some, but not all, studies using registry data have suggested a small but significant long-term survival advantage following a curative surgical resection of gastric cancer at hospitals where the volume of such surgeries is high. However, because such data may be significantly influenced by the impact of pos...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000245469.35088.42
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the survival and function of hepatocytes (HCs) on a novel three-dimensional (3D) synthetic biodegradable polymer scaffold with an intrinsic network of interconnected channels under continuous flow conditions. SUMMARY BACKGROUND DATA:The authors' laboratory has investigated HC transplantation usin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199807000-00002
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:Mycophenolate mofetil (MM) is a new immunosuppressive agent that reversibly inhibits guanine nucleotide synthesis and DNA replication. Its activity is highly selective for T and B lymphocytes. Two open-label multicenter trials of MM in renal transplantation have been performed. This report summarizes the resu...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-199305010-00007
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To follow up in prospective fashion patients with coronary artery anastomoses completed endoscopically with robotic assistance. The robotic system was evaluated for safety and its effectiveness in completing microsurgical coronary anastomoses. SUMMARY BACKGROUND DATA:Recently there has been an interest in us...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-200106000-00001
更新日期:2001-06-01 00:00:00
abstract::Adenocarcinoma involving the distal esophagus usually is far advanced when the patient is first seen. Adenocarcinoma differs from squamous carcinoma of the esophagus since it is relatively unresponsive to radiation therapy or chemotherapy. Adenocarcinoma of the esophagus resembles gastric cancer in its tendency to for...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198705000-00015
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:The authors determined whether radioligand binding of neuropeptide Y (NPY) to hypothalamus taken from nonanorectic and anorectic tumor-bearing rats was altered as compared with similar tissue taken from freely-feeding and food-restricted control rats. SUMMARY BACKGROUND DATA:Previous results indicate that tu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199505000-00016
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Ventricular assist devices (VADs) have been used for temporary circulatory support pending transplantation or recovery of the native heart. Outcome in 38 patients treated at the authors' institution with VADs pending transplantation was analyzed to provide information relevant to the future use...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199706000-00007
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:To characterize the scope and magnitude of practice variation associated with the diagnosis and treatment of appendicitis at freestanding children's hospitals. BACKGROUND:Variation in care has been associated with poor outcomes and is believed to be a key driver of excess health care spending. METHODS:Retro...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000246
更新日期:2014-06-01 00:00:00
abstract::The role of surgery in the treatment of gastrinoma is unclear. The purpose of this study was to determine prospectively the surgical cure rate using a controlled clinical trial. Eleven patients who fit the entry criteria underwent abdominal exploration and attempted tumor resection for cure. A historical control group...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199001000-00002
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:To determine whether ischemic preconditioning protects the human liver against a subsequent period of ischemia in patients undergoing hemihepatectomy, and to identify possible underlying protective mechanisms of ischemic preconditioning, such as inhibition of hepatocellular apoptosis. SUMMARY BACKGROUND DATA...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200008000-00001
更新日期:2000-08-01 00:00:00