Ten years of breast screening in the Screening Mammography Program of British Columbia, 1988-97.

Objectives: To evaluate 10 years outcomes of the Screening Mammography Program of British Columbia (SMPBC) and determine if breast screening targets were being achieved among women aged 40-80+ years.

Setting: Organised breast screening programme in British Columbia, Canada.

Methods: Rates of participation, abnormal referral, cancer detection, and interval cancer were calculated for asymptomatic women receiving an SMPBC mammography from 1988-97.

Locoregional first recurrence after mastectomy: prospective cohort studies with and without immediate chemotherapy.

Purpose: To evaluate prospectively the impact of combination chemotherapy in the combined modality treatment of isolated first locoregional recurrence (LRR) following mastectomy for breast cancer.

Methods And Materials: Between 1979 and 1989, 120 chemotherapy-naive women with isolated LRR as first failure after mastectomy were prospectively identified, uniformly staged, and systematically followed. Treatment consisted of excision if feasible, radical locoregional radiotherapy, and a hormonal maneuver (unless estrogen receptor negative).

Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer.

Background: Radiotherapy after mastectomy to treat early breast cancer has been known since the 1940s to reduce rates of local relapse. However, the routine use of postoperative radiotherapy began to decline in the 1980s because it failed to improve overall survival. We prospectively tested the efficacy of combining radiotherapy with chemotherapy.

Late cosmetic results of short fractionation for breast conservation.

Background And Purpose: The number of fractions of radiation therapy (RT) used after breast conserving surgery varies widely and accounts for a significant proportion of the workload in a modern radiotherapy department. Internationally, 'standard' therapy ranges from 3 to 7 weeks of daily treatment with or without a boost. Short RT schedules have the attraction of reducing workload but raise concern about an increased risk of late effects and poorer cosmetic outcome.

Effect of acetylsalicylic acid on radiation and cosmetic results after conservative surgery for early breast cancer: a randomized trial.

Background And Purpose: Acetylsalicylic acid (ASA) can reduce the incidence of stroke and myocardial infarction by inhibiting platelet-fibrin thrombi in small blood vessels. To determine if ASA could reduce late effects of radiation therapy mediated by damage to small blood vessels, a prospective, placebo-controlled, double-blind trial was conducted in women with early breast cancer, receiving radiotherapy to the conserved breast.

Materials And Methods: Cosmetic outcome and late radiotherapy effects were recorded prospectively for 186 women with T1 or T2, pathologically node-negative breast cancer treated with breast conservation and randomized to receive ASA (325 mg daily) or placebo for 1 year from the start of radiation therapy.

Comparison of partial and modified radical mastectomy in the community setting--"10 years later".

Conservative surgery followed by postoperative radiation is considered equivalent to a modified radical mastectomy (MRM) for the treatment of early breast cancer. It cannot be assumed that results from selected academic centres are equivalent to those obtained in the general community setting, because there may be differences in patient selection or surgical or radiotherapy techniques that may adversely affect outcome. A quality-control study of women who were seen at the British Columbia Cancer Agency and were treated by partial mastectomy (PM) was begun in 1983.

Combined modality therapy of Hodgkin's disease: 10-year results of National Cancer Institute of Canada Clinical Trials Group multicenter clinical trial.

The purpose of this study was to compare four methods of treatment for stage III-IV Hodgkin's disease. Between January 1972 and September 1976, 266 patients with stage IIIB, IVA, and IVB Hodgkin's disease from 21 cancer treatment centers across Canada were registered as eligible; 40 were found to be ineligible. Of the 226 remaining patients, only seven were followed for less than 10 years.

The Screening Mammography Program of British Columbia: pilot study.

A government-funded pilot project of high volume screening mammography was conducted in Vancouver, British Columbia. 7,100 women were screened over a 9-month period, averaging 43 women per day at a cost of $33.81 per woman screened.

Early breast cancer: detection of recurrence after conservative surgery and radiation therapy.

To determine the clinical and mammographic features of recurrent breast cancer after tumorectomy and radiation therapy, the authors reviewed the clinical history and serial mammograms of 48 patients with suspected recurrence. Of patients with recurrent disease, seven had positive mammograms alone, nine had positive findings at physical examination alone, and eight had both positive mammograms and positive results of physical examination. Positive mammographic findings included the development of new fine calcifications (six patients), a new mass (five patients), mass and calcifications (one patient), increasing opacity (two patients), or skin thickening (one patient).

Postmastectomy lymphedema treated with the Wright linear pump.

Fifteen patients with postmastectomy lymphedema of the arm were treated with the Wright linear pump, a programmable, gradient pressure, sequential, intermittent compression pump. The group comprised volunteers in whom conservative measures had failed. This is a phase II trial to determine the efficacy of the pump.

Breast cancer after treatment for osteosarcoma.

Two cases of patients with primary osteosarcoma who developed subsequent new primary infiltrating ductal carcinoma of breast are presented. The relationship of irradiation from diagnostic radiology, chemotherapy given, and possible genetic factors are discussed. A recommendation for the lifetime follow-up program of a patient with osteosarcoma should include careful attention to breast self-examination and regular breast examination by the attending physician.

Radiation dose and second breast cancer.

Amongst 14,000 women with breast cancer treated between 1946 and 1982, 194 developed a second primary tumour in the contralateral breast more than one year after diagnosis of the first primary. The radiation dose to the contralateral breast was calculated for each member of this group and also for members of a control group matched for age, year of diagnosis and survival time. Comparison of the groups provides no evidence for radiation induced carcinogenesis on the contralateral breast in these patients.

Bacille Calmette-Guérin as maintenance therapy for non-Hodgkin's lymphoma.

Following complete remission of non-Hodgkin's lymphoma by chemotherapy, irradiation or both, 44 patients were studied to assess the value of bacille Calmette-Guérin (BCG) as maintenance therapy. Patients with stage LI, EI or EII disease were allocated at random to receive BCG or no further maintenance therapy, and those with stage LII, LIII, EIII or IV disease received BCG therapy or orally administered cyclophosphamide. BCG had no effect on the duration of remission or the overall survival from the time of randomization.

Laparotomy for staging of Hodgkins' disease.

Laparotomy was used for staging Hodgkin's disease in a selected group of 71 patients over a 9-year period at the Cancer Control Agency of British Columbia. Operative results altered the staging in 30 patients and the treatment in 28 patients. Negative lymphangiograms were found to predict accurately the absence of abdominal lymph-node involvement.