Showing papers by "John F. Forbes published in 1993"
TL;DR: Issues are addressed with particular emphasis on the biologic relevance of tumor recurrence for planning local treatment, the management of subclinical radiographic abnormalities, the degree of importance of the timing of surgery in the menstrual cycle, and the value of axillary dissection.
Abstract: Randomized clinical trials evaluating local treatments for early breast cancer have provided new data on the long-term morbidity and cause-specific mortality associated with radiotherapy combined with different types of mastectomy. The difficulty surgeons have in determining optimal integration of surgery and radiotherapy for breast preservation is demonstrated by the wide variation of radiotherapy schedules, lack of interpretable data to justify a radiotherapy "boost," and data from a randomized trial suggesting that radiotherapy applied only to the excision site might be sufficient. The use of cytology aspirates for tumor grading, the prognostic importance of vascular invasion, and new tumor markers and cancer cells in bone marrow at diagnosis are all reported. New data came from attempts to identify an axillary sentinel node at surgery for breast cancer. Studies of connective tissue disorders in women with silicone implants failed to find evidence of increased risk, but 3-year follow-ups confirmed that surgeons who preferred mastectomy are more likely to have anxious, depressed patients.
2 citations
1 citations