Clinical Trials for Ductal Carcinoma In Situ of the Breast.

Ductal carcinoma in situ (DCIS) of the breast is a non-obligatory precursor to invasive breast carcinoma, with a variable natural history and biological potential for progression to invasive disease. Over the past 30 years, clinical trials have applied the therapeutic principles used for invasive carcinoma to treat DCIS (surgery, with or without breast radiotherapy, and post-operative endocrine therapy), with excellent survival outcomes, and in-breast recurrence rates that range from 0.5 to 1% annually.

Neoadjuvant treatment response in negative nodes is an important prognosticator after esophagectomy.

Background: The current American Joint Committee on Cancer Seventh Edition (AJCC7) pathologic staging for esophageal adenocarcinoma (EAC) is derived from data assessing the outcomes of patients having undergone esophagectomy without neoadjuvant treatment and has unclear significance in patients who have received multimodality therapy. Lymph nodes with evidence of neoadjuvant treatment effect without residual cancer cells may be observed and are not traditionally considered in pathologic reports, but may have prognostic significance.

Methods: All patients who underwent esophagectomy after completing neoadjuvant therapy for EAC at our institution between 2006 and 2012 were reviewed.

24-h multichannel intraluminal impedance-pH monitoring may be an inadequate test for detecting gastroesophageal reflux in patients with mixed typical and atypical symptoms.

Background: The detection of gastroesophageal reflux (GERD) via pH testing is the key component of the evaluation of patients considered for antireflux surgery. Two common pH testing systems exist, a multichannel, intraluminal impedance-pH monitoring (MII-pH) catheter, and wireless (Bravo(®)) capsule; however, discrepancies between the two systems exist. In patients with atypical symptoms, MII-pH catheter is often used preferentially.

Ambulatory esophageal pH monitoring.

The development and advancement of ambulatory esophageal pH monitoring has provided a key tool with which pathologic esophageal acid exposure can be objectively measured; although not perfect, it provides the clinician with arguably the most important piece of information in the diagnosis and management of patients with gastroesophageal reflux disease. It is also important to emphasize that, although esophageal pH monitoring can reliably measure esophageal acid exposure, assessing the relationship of abnormal findings and the patients' symptoms is a much more complex matter and, of course, the key to successful treatment outcomes.