The Breast : official journal of the European Society of Mastology
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Intraductal carcinoma of the breast (DCIS), by definition, cannot give axillary metastases. Axillary dissection is therefore not indicated. The role of the sentinel lymph node (SLN) biopsy in the management of DCIS has not yet been established. ⋯ SLNB should be considered in case of DCIS where there exists a strong doubt of invasion at the definitive histology, such as large solid tumours or diffuse or pluricentric microcalcifications undergoing mastectomy. Moreover, if the trend is statistically confirmed with a wider population, large comedo-DCIS, presenting superior risk of SLNs metastasis, could be scheduled for SLNB. If the SLN is micrometastatic complete axillary dissection is not unavoidable.
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Randomized Controlled Trial Comparative Study Clinical Trial
Management of lactational breast abscesses.
The purpose of the present prospective study was to compare incision and drainage against needle aspiration for the treatment of breast abscesses in lactating women. During the 3-year study period, patients with breast abscesses were randomized 1:1 to undergo either incision and drainage (23 patients) or needle aspiration (22 patients). Ultrasound guidance was not used for any of these patients. ⋯ The risk factors for failure of needle aspiration for breast abscesses were abscesses larger than 5 cm in diameter, unusually large volume of aspirated pus, and delay in treatment. In conclusion, breast abscesses smaller than 5 cm in diameter on physical examination can be treated with repeated aspirations with good cosmetic results. Incision and drainage should be reserved for use in patients with larger abscesses.
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This descriptive population-based study estimates the incidence, and describes the management and outcomes for women diagnosed with gestational breast cancer (GBC) aged 15-44 years in Western Australia between January 1982 and December 2000. Gestational breast cancer accounted for 6.25% of breast cancers in Western Australian women less than 45 years of age, and complicated 23.6 per 100,000 pregnancies. Two thirds were diagnosed postpartum and a third while pregnant. ⋯ Five-year survival was better than reported previously (73%). The incidence of GBC was lower than previously reported. Significant differences in pregnancy outcome and management exist between the pregnant and postpartum groups.
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There is increasing use of luteinising hormone-releasing hormone (LHRH) agonists in the adjuvant treatment of breast cancer (J. Clin. Oncol. 19(2) (2001) 343). ⋯ Soc. Clin. Oncol. 22 (2003), Abstr. 15).
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Women are conventionally advised to stop tamoxifen before attempting pregnancy. The risks of congenital malformations or late teratogenic manifestations in adulthood are unknown. Following an informed discussion about the uncertainties of tamoxifen exposure on pregnancy women should be offered the choice whether to continue or stop tamoxifen before attempting pregnancy. An unexpected pregnancy in a women taking tamoxifen could continue if the pregnant woman accepts the possibility of a teratogenic effect that tamoxifen could have on the fetus.