Tattooing breast cancers treated with neoadjuvant chemotherapy.

Background: In breast carcinomas treated with neoadjuvant chemotherapy, intraoperative identification of residual tumors may be difficult. A well-tolerated, low-diffusion charcoal suspension has been designed to tattoo breast tumors. In this study, we investigated whether this tattooing technique is efficient for localizing the tumor after treatment with chemotherapy.

Immediate reconstruction after neoadjuvant chemotherapy: effect on adjuvant treatment starting and survival.

Background: For patients treated with initial surgery, the safety of immediate breast reconstruction after mastectomy has been demonstrated. Some concerns exist after neoadjuvant chemotherapy because this sequence is proposed for patients with large tumors and for whom adjuvant therapies are considered cornerstones of treatment. In this study, we sought to determine whether reconstruction after neoadjuvant chemotherapy and mastectomy for large operable breast cancer affects the interval between surgery and adjuvant treatment and affects survival.

[Axillary lymphadenectomy with muscular padding, without drainage].

Objective: Axillary padding without drainage appeared to be a valuable alternative technique to vacuum drainage. The technique employs local muscles or the axillary aponeurosis for padding. We report here the clinical evaluation of muscular padding without drainage.

[Radiotherpay and immediate breast reconstruction with myocutaneous flap in breast cancer of reserved prognosis].

In France, immediate breast reconstruction (IBR) for infiltrating carcinoma remains controversial. Many teams advocate the possible event of a post mastectomy radiotherapy and its negative effect on IBR. In our Institute we do not exclude infiltrating breast cancer patient from IBR.

[Efficacy of massage and mobilization of the upper limb after surgical treatment of breast cancer].

We have compared different modes of rehabilitation after breast cancer surgery on a population of 257 patients treated at the Institute Gustave-Roussy in 1990 and 1991. The mode of rehabilitation was randomized according to a 2 X 2 design, between physiotherapy alone, shoulder movement alone, both or neither. Treatment began the day after breast surgery and continued for 7 days.

[Breast reconstruction using free rectus abdominis myocutaneous flap].

More than 50% of patients who have breast cancer do not need a mastectomy. Since 1976, reconstruction of the breast is suitable. From 1976 to 1995, we have performed 220 breast reconstructions with a pediculed latissimus dorsi and 510 reconstructions with a pediculed transverse rectus abdominis myocutaneous flap (TRAM).

[Rectus abdominis myocutaneous flaps].

The free transverse rectus abdominis myocutaneous (TRAM) flap is vascularized by the inferior epigastric pedicle. There are many techniques according to the indication. We describe the technique for breast reconstruction after mastectomy for cancer.

[Role of immediate reduction mammaplasty and mammapexy in the conservative treatment of breast cancers].

For some years, breast cancer surgery has become increasingly conservative, in order to preserve the aesthetic aspect of the treated breast and global harmony of the bosom. Unfortunately, conservative treatment is followed by 20% to 30% of unsatisfactory cosmetic results. Some studies have defined the various factors associated with an increased failure rate in terms of cosmetic results.

[Intraductal carcinoma of the breast (DCIS). Should the treatment be conservative or not?].

Due to systematic mammography, DCIS is being seen with increased incidence than in the past. Asymptomatic women screened by mammography show a high incidence of microcalcifications. Lymph node involvement is seen in very few patients.

Risk factors for failure of immediate breast reconstruction with prosthesis after total mastectomy for breast cancer.

Background: Immediate breast reconstruction (IBR) after mastectomy represents a clear improvement in the quality of life of patients with breast cancer, but prosthesis removal is relatively frequent. Therefore, it is important to identify risk factors related to this removal.

Methods: A series of 142 patients treated with mastectomy and IBR at the Institut Gustave-Roussy between January 1976 and December 1988 were studied.

[Immediate breast reconstruction: indications and technics. Apropos of 120 cases treated at the Institut Gustave-Roussy].

From 1976 to 1986 one hundred and twenty immediate breast reconstructions (IBR) were performed at the Gustave-Roussy Institut. 90% of these cases were treated for in situ or infiltrating carcinomas, while only 10% had prophylactic mastectomy. Over recent decades indications for IBR have progressively changed.