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  • 1
    ISSN: 1432-1084
    Keywords: Breast neoplasms, diagnosis ; Breast neoplasms, MR studies ; MRI, Gd-DTPA ; MRI, technology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract State-of-the-art screening mammography allows the detection of nonpalpable breast lesions in approximately 30 % of patients. The presence of clustered microcalcifications without evidence of solid tumors usually requires further investigations, mainly biopsy. A 1.5-T magnet with a single breast coil was used to evaluate 32 patients with indeterminate mammography suggestive of microcalcifications prior to surgery. Both spin-echo (SE) and gradient-echo (GE; 2D fast low-angle short [FLASH]) techniques were utilized before and after injection of 0.2 mmol/kg Gd-DTPA. Upon surgery tumor diameters ranged between 3 and 10 mm. Use of MRI demonstrated 87.5 % overall accuracy, 83.3 % sensitivity, and 92.9 % specificity. False-negative MRI results were in situ carcinomas less than 5 mm in size. All the correctly diagnosed carcinomas measured between 5 and 10 mm. Partial volume is probably the greatest limit of this technique and lesions equal to or smaller than 5 mm are only rarely detected. The GE and SE sequences demonstrated comparable results.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0350
    Keywords: Key words Infantile brain tumors ; Childhood brain radiotherapy ; Usefulness of chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  To reduce the sequelae from CNS irradiation (RT), 16 children younger than 3 years with medulloblastoma-PNET (13 cases) and ependymoma (3 cases) were treated between 1987–1993 according to different postsurgical chemotherapy (CT) programs. None of these patients presented with metastases. Eleven patients were rendered disease-free by surgery, while 5 had residual tumor. Adjuvant therapy depended on patients’ age, postsurgical status and parents’ consent to radiotherapy (RT). Nine of the 16 infants remained alive in continuous complete remission from the first neoplasm (median follow-up 7 years). Three of them had been treated with CT alone and 6 with combined CT+RT (posterior fossa 4, whole CNS 2). Seven patients relapsed a median of 13 months after diagnosis, and all 7 of them died of their disease. Despite the omission of RT in 6 of the 16 patients and administration of only focal RT in 8 of the 16, the outcome of this series was satisfactory. Local failure (in 5/7 patients) was the major problem, despite the high dose of RT used in 2 of these 5. In 4 of 6 evaluable children school performance was satisfactory. One child in whom the entire CNS was irradiated developed glioblastoma multiforme 120 months after the first diagnosis of medulloblastoma.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7217
    Keywords: breast cancer ; diagnostic accuracy ; follow-up ; recurrence site ; symptomatology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary From June 1973 to May 1978 a total of 845 patients with operable breast cancer were entered into different adjuvant programs. The medical records of the 278 patients showing relapse were carefully re-evaluated to assess the pattern(s) of first recurrence and the consistency of follow-up modulation. Ninety-one of 179 patients treated with surgery alone, 130 of 414 given 12 cycles of adjuvant CMF and 57 of 252 treated with 6 cycles of CMF showed treatment failure within 5 years from radical mastectomy. Thefrequency of new disease manifestations was significantly affected by primary treatment, since patients given adjuvant CMF showed a lower tendency to recur in local-regional area(s) and in bone(s). However, in relapsed patients,patterns of new lesions were not substantially altered by type of primary treatment. The most frequently involved sites were soft tissues (37.8%) and bones (37%) followed by viscera (34.2%). Retrospective evaluation of X-rays revealed that in 26.2% of osseous metastases, diagnosis could have been assessed earlier, with a median delay of 4 months (range 1–8). Present analysis also revealed that short-term repeated X-ray examinations yielded findings more controversial than reliable for assessing the exact time of relapse, thus preventing firm conclusions in the presence of suspicious recurrence. A new follow-up schedule after completion of adjuvant chemotherapy is proposed, since on the basis of our experience, in asymptomatic patients frequently repeated examinations are not necessary and some can safely be omitted.
    Type of Medium: Electronic Resource
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