Cancer
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To evaluate the pathologic characteristics of the primary tumor relative to local control, survival, and freedom from distant metastases, an analysis was performed of 172 patients with ductal carcinoma in situ (intraductal carcinoma) of the breast treated with breast-conserving surgery and definitive breast irradiation. ⋯ These results have demonstrated that there are important differences in the rate of local recurrence based on the pathologic characteristics of the primary tumor for women with ductal carcinoma in situ treated with breast-conserving surgery and definitive irradiation. However, the differences in local recurrence have not been associated with differences in survival or freedom from distant metastases. Careful follow-up for patients at increased risk for local recurrence is warranted because of the potential ability to salvage patients with local recurrence.
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Most cases of superior vena cava (SVC) syndrome are secondary to malignant disease and subacute in their presentation. Acute cases of SVC syndrome have been described, with the majority of these being precipitated by thrombosis after central venous catheterization. The authors report a case of acute SVC syndrome after central venous catheter placement, which was not due to thrombosis, but rather caused by a catheter occluding a previously subclinical stenosis of the SVC. Resolution of the clinical SVC syndrome occurred after catheter withdrawal.
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This case study demonstrates the similarity between the development of dogma and the persecution of deviants during the Spanish Inquisition and that in medicine using breast cancer as an example. Regarding breast cancer, the dogma of therapy became separate from the underlying hypothesis and, like the religious dogma enforced by the Inquisition, it required inflexible adherence. ⋯ This serves to inhibit debate and the exploration of alternative hypotheses, both of which are essential for the advancement of scientific knowledge. Adherance to dogma is antithetical to the conditional and approximate nature of truth in science.