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  • 1
    Electronic Resource
    Electronic Resource
    Clinical and Pathologic Features of Breast Cancers in Women Treated for Hodgkin's Disease: A Case-Control Study (2001)
    Boston, MA, USA : Blackwell Science Inc
    The @breast journal 7 (2001), S. 0 
    Details
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: The goal of this study was to assess whether there are clinical or pathologic differences between radiation-associated breast cancers developing after treatment for Hodgkin's disease and spontaneously arising breast cancers. Clinical and pathologic data were reviewed for 26 Hodgkin's disease patients who received irradiation and subsequently developed breast cancer (cases) and 26 age- and stage-matched patients with sporadic breast cancers (controls). The median age at diagnosis of Hodgkin's disease was 21 years (range 11–40 years), and the median interval between Hodgkin's disease and breast cancer diagnosis was 15 years (range 4–27 years). There were no differences between cases and controls with regard to clinical factors. Cases had a lower frequency of histologic grade III tumors (38% versus 65%, p = 0.09) and moderate to marked mononuclear inflammatory cell reaction (11% versus 35%, p = 0.03). When these covariates were combined, grade III tumors in conjunction with mononuclear inflammatory cell reaction were also seen less frequently in the case group than in the control group (11% versus 31%, p = 0.06). Seven cases developed additional cancers, but no additional cancers developed in the control group (p = 0.01). Patients who developed breast cancers after Hodgkin's disease did not differ from patients with spontaneous breast cancers, with regard to clinical factors. However, the lower frequency of high-grade tumors and moderate to marked mononuclear inflammatory cell reaction among the cases suggests that radiation-associated breast cancers may differ from spontaneously arising cancers in their pathogenesis. Cases appeared to be at increased risk of developing additional cancers, but we cannot exclude surveillance as a possible contributing factor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1524-4741.2001.007001046.x
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  • 2
    Electronic Resource
    Electronic Resource
    The role of staging laparotomy in combined modality therapy of Hodgkin's disease: A new treatment plan based on a 6-year experience (1978)
    Springer
    World journal of surgery 2 (1978), S. 101-105 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Entre 1969 et 1974, 187 malades atteints de maladie de Hodgkin ont subi une laparotomie pour préciser le stade de l'affection. Dans 59 cas (32%), cette exploration a modifié le plan thérapeutique. Les réévaluations les plus importantes ont été: 20 cas sont passés du stade IIA au stade IIIA, 6 de IIIA à IA, 14 de IIIA à IIA, 12 de IIB à IIIB et 4 de IIIB à IIB. Sur 101 malades classés stade II, 32 (32%) sont devenus des stades III; sur 61 malades classés stade III, 24 (39%) sont passés aux stades I ou II. Quarante-quatre malades au stade IIIA ont reçu une irradiation ganglionnaire totale de 3600–4000 rad, et leur espérance de survie à 5 ans sans récidive est de 52%. Il n'y a eu aucune récidive chez 11 patients au stade IIB traités par irradiation en capeline et périaortique combinée à une chimiothérapie (moutarde azotée, vincristine, procarbazine et prednisone: MOPP). Sur 19 cas au stade IIIB traités par irradiation ganglionnaire totale et MOPP, 3 seulement ont récidivé. Il y a 100% de survies sans récidive pour les malades au stade IIB traités par irradiation + MOPP, et 77% pour les stades IIIB. Ces résultats remarquables nous ont amenés à modifier les schémas thérapeutiques. Les stades IIA clinique et IIA histologique, et les stades IIB sont maintenant traités par irradiation en capeline et périaortique + MOPP. Les stades IIIA clinique et IIIA histologique, et les stades IIIB sont traités par irradiation ganglionnaire totale + MOPP. Dans notre série, la laparotomie s'est donc révélée être un acte essentiel pour prescrire une thérapeutique précise et efficace.
    Notes: Abstract From 1969 to 1974, staging laparotomy was performed on 187 consecutive patients with Hodgkin's disease. Laparotomy changed the type of therapy in 59 of 187 patients (32%). Major staging revisions were: IIA to IIIA, 20 patients; IIIA to IA, 6 patients; IIIA to IIA, 12 patients; IIB to IIIB, 14 patients; and IIIB to IIB, 4 patients. Of stage II patients, 32 of 101 (32%) became stage III and of stage III patients, 24 of 61 (39%) became stage I or II. Forty-four patients with stage IIIA disease received 3,600–4,000 rad total nodal irradiation and their probability of relapse-free survival at 5 years was 52%. No relapses occurred in 11 stage IIB patients given combination of mantle and periaortic irradiation plus MOPP. Only 3 of 19 stage IIIB patients treated with total nodal irradiation and MOPP relapsed. Stage IIB patients with combined therapy had a diseasefree survival of 100%, while stage IIIB patients had a relapse-free survival of 77%. These striking results have led to a new treatment plan. Clinical stage IIA, pathological stage IIIA patients, and those with stage IIB disease now receive a combination of mantle and periaortic irradiation plus MOPP. Clinical stage IIIA, pathological stage IIIA patients, as well as those with stage IIIB disease, receive total nodal irradiation and MOPP. Surgical staging in this series has proved essential for effective and precise therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01574473
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