Abstract: AIMS AND BACKGROUND: The aim of our study was to estimate the incidence of second primary tumors among breast cancer patients from the Division of Oncology of Andosilla Hospital (Viterbo, Italy). In particular, we studied the relationship between breast and colorectal cancer. METHODS AND STUDY DESIGN: Eligible women were those with primary invasive breast cancer who had been treated and/or followed up at our division. We compared our data with those reported in the literature. RESULTS: Of 114 women with breast cancer, 21 (18.5%) developed multiple primary cancers, with colorectal cancer accounting for a quarter. We found a higher incidence of colorectal cancer than reported in the literature (5% vs 0.66-1%). At the moment we are not able to explain this difference. CONCLUSIONS: Quite a few studies reported a link between breast and colorectal cancer, but the magnitude of the risk (standardized incidence ratio 1.3-2) does not justify a screening program for colorectal disease in breast cancer patients. However, considering that the risk is small but not negligible--along with the high incidence of colorectal adenomas described in breast cancer patients and the possible existence of common risk factors--we invite clinicians not to neglect the possibility of a colorectal cancer diagnosis in women who have had breast cancer.
Abstract: The diagnostic differentiation of breast lesions is very important because of the frequency with which they occur. Though fibroadenoma is easy to diagnose, some cases prove really hard to distinguish. Therefore, various methods have been suggested both for diagnosis and therapy, but no common approach has been achieved to date. We report our experience with 1350 cases diagnosed over a twenty-year period. The diagnosis was made on the basis of a diagnostic protocol drawn up over the years where cytology is of primary importance. With regard to therapy, we decide to operate when the cytological findings prompt the need for a histological examination of the lesion. Moreover, we operate on those cases where either an increase in size or a morphological change of the lesion has taken place. Histological examinations were carried out in 420 cases out of 1350 and only one of these cases turned out to be a carcinoma. As a result, the 0.24% error in the diagnosis can be considered irrelevant. In spite of the different therapies suggested (cryoablation, laser hyperthermia, i.a.), we believe that surgical treatment with local anaesthetic is the most suitable solution in those cases requiring treatment. Obviously, the diagnosis has to be accurate and made by surgeons with appropriate expertise. When the diagnosis is certain and the conditions of the lesion are stable, the best policy seems to be periodic follow-up.
Abstract: Financing health-care expenditure has become increasingly more difficult. Considering the high frequency of breast cancer, which affects one million women in the world each year, the reductions of medical expenditure for the treatment of this disease is highly desirable within the limits of medical efficiency and safety. One hundred and fifty patients with carcinoma of the breast underwent surgery in our department with one-day hospitalization. Patients were discharged with the drainage tube still in place and later treated in the out-patient setting, for dressing and checking the wound, and removing the stitches and drainage tube. Four cases of seroma were registered, all resolved by aspiration of the fluid in a single visit, 1 case of haematoma and 1 case of infection. Patients who underwent this short-stay treatment were amply satisfied. Our experience demonstrates that this type of treatment is both safe and effective. Moreover, it provides considerable benefits in terms of national health-care costs as well as being psychologically better for the patients.
