Clinical Evidence of Parasternal Lymph Node Involvement in Neoplastic Disease
|
|
- George McBride
- 6 years ago
- Views:
Transcription
1 Acta Radiologica ISSN: (Print) (Online) Journal homepage: Clinical Evidence of Parasternal Lymph Node Involvement in Neoplastic Disease D. W. Smithers & P. Rigby-Jones To cite this article: D. W. Smithers & P. Rigby-Jones (1959) Clinical Evidence of Parasternal Lymph Node Involvement in Neoplastic Disease, Acta Radiologica, 51:sup188, , DOI: / To link to this article: Published online: 14 Dec Submit your article to this journal Article views: 797 View related articles Citing articles: 4 View citing articles Full Terms & Conditions of access and use can be found at
2 FROM THE RADIOTHERAPY DEPARTMENT, ROYAL MARSDEN HOSPITAL AND INSTITUTE OF CANCER RESEARCH: ROYAL CANCER HOSPITAL (DIRECTOR: PROF. D. w. SMITHERS), LONDON, ENGLAND CLINICAL EVIDENCE OF PARASTERNAL LYMPH NODE INVOLVEMENT IN NEOPLASTIC DISEASE by D. W. Smithers and P. Rigby-Jones INTRODUCTION... It is the fact that in more than half my recurrent cases, before I began the prophylactic use of radium, the return of the disease manifested itself either by an enlargement of the gland at the lower and inner angle of the posterior triangle, or by the appearance of nodules, later merging in sternal recurrence, upon the deep fascia at the inner end of the first, second, or third intercostal spaces. The position of these recurrences accurately along the line of the internal mammary artery shows I think beyond doubt that they are due to invasion of the lymphatic glands which lie along its course. - W. SAMPSON HANDLEY, 1927 (b). Sampson Handley was of course speaking of carcinoma of the breast. Through the work of his son, Richard Handley, the frequency of involvement of parasternal nodes in this disease has at last been recognised and a great deal of interesting histological work has been done. Little, however, even now, has appeared in support of SAMPSON HANDLEY s original clinical observation of parasternal lymph node involvement from breast tumours, and nothing, that we know of, about metastatic involvement of these nodes from primary tumours elsewhere. Our interest in this subject was aroused in 1943 when one of us saw a patient aged 75 with a recurrence to one side of the sternum, whose breast had been removed by Mr. Sampson Handley twenty-five years before and for whom he had done a parasternal radium implant for a recurrence seven years later. He had published an account of this case (HAND- LEY, 1927 (a)) as one showing clinical evidence of involvement of these nodes, having drawn attention to their histological involvement in other cases five years before (HANDLEY, 1922). When we advised this patient to go back to see Mr. Sampson Handley in 1943, he wrote in his reply:... I have not been able to persuade the profession that the int. mammary chain of glands is infected in breast cancer just as soon as the axillary chain, and that a carcinoma operation is consequently incomplete until radium tubes have been introduced above the first rib & at the inner ends of the intercostal spaces....
3 236 D. W. SMITHERS AND P. RIGBY-JONES Fig. 1. Sclerosis in sternum following radium implant to parasternal node recurrence. 24 years previously. He reported this patient again at a meeting of the Royal Society of Medicine (HANDLEY, 1950), and for good measure Fig. 1 is an X-ray of the sclerosis which occurred in the sternum in this patient 24 years after Sampson Handley s radium implant. As a result of this experience in 1943 we began both to collect clinical evidence of parasternal lymph node involvement and also to give radiotherapy to the parasternal region in a group of patients with upper and inner quadrant breast tumours. For this purpose special triangular shaped applicators, one for each side, were made (Fig. 2), to include the intercostal spaces in the X-ray field. The post-operative X-ray fields used at that time are illustrated in Fig. 3 and consisted of a direct parasternal triangular field, two tangential chest wall fields, a central scar field treated to a low dose and at low voltage (since abandoned), an anterior supraclaviculo-axillary field, and a posterior axillary field. The parasternal field was at first used only for upper and inner quadrant tumours and not for all of these.
4 PARASTERNAL LYMPH NODE INVOLVEMENT IN NEOPLASTIC DISEASE 237 Fig. 2. Triangular shaped applicators used for irradiation of intercostal spaces in Fig. 3. Old arrangement of fields for 'postoperative treatment in carcinoma of the breast. Following the publication of Richard Handley's work (HANDLEY and THACK- RAY, 1947), the frequency of involvement of nodes at this site was at last appreciated, and the irradiation of the parasternal node regions then became a routine for patients with inner half tumours in our hospital and was also employed for patients with outer half tumours who were known to have or suspected of having axillary node involvement. Evidence that recurrence in this region was less common when parasternal X-ray fields had been used, was first reported by us six years ago (RIGBY- JONES, 1953), and a summary of what was recorded then is given in Table 1. Tumours arising in the inner half of the breast have a relatively poor prognosis compared to those in the outer half in Stage I but not in later stages. This is due to the difficulty of detecting early parasternal lymph node enlargement clinically, with the result that more patients with inner half than with outer half tumours placed in Stage I do in fact have lymph node involvement (SMITHERS, 1958). During these last fifteen years our clinical examples of metastatic involvement of parasternal lymph nodes have been accumulating. These have naturally resulted predominantly from primary breast carcinomas, but a variety of neoplasms of other primary sites may metastasise to these nodes. In this paper we propose to discuss the evidence for the frequency with which lymph node metastases occur at this site from carcinoma of the breast and to give some information on cases in which we have been able to observe such involvement clinically; we shall also give a brief
5 238 D. W. SMITHERS AND P. RIGBY-JONES Table 1 The effectiveness of parasternal irradiation in preventing early parasternal recurrence Site of primary tumour in the breast Inner half.... Outer half..... Central... Diffuse.... Unspecified.... (from RIGBY-JONES, 1953) I First treatment including 1 First treatment not including Darasternal irradiation I parasternal irradiation Total first Parasternal 1 Total first Parasternal I recurrences I recurrences I I Total I 0 I 302 I 16 account of those cases in which we have detected metastases in these nodes from other primary tumours Frequency of Involvement of Parasternal Lymph Nodes in Patients with Breast Carcinoma It was the anatomical work of STIBBE (1918) on the internal mammary lymph nodes, first suggested by Sampson Handley, that led to an investigation into their involvement in neoplastic disease of the breast. Stibbe examined 60 subjects, a bilateral dissection of each intercostal space being carried out. The average number of these nodes that he was able to find at all ages and on both sides was 8.5. The nodes were found more frequently in young than in old people, the average number found in infants being 11.4, and in those over seventy years of age 6.6. Nodes were most frequently located in the first and second spaces, the third space came a good third, but other spaces contained nodes more rarely. Stibbe quoted an interesting observation from Halsted, who had described how his house surgeon, in 1898, had dissected the parasternal lymph nodes from three patients with recurrent breast tumours. HALSTED S interest had lain more with axillary and supraclavicular node involvement and he gave an account in 1907 of 101 cases in which he had done a supraclavicular node dissection. It was the work of Sampson Handley which called attention to the frequency of involvement of parasternal lymph nodes in carcinoma of the breast. This work was referred to in his book published in 1922 when he described the use of radium tubes in the treatment of these nodes. He had himself been using this radium technique since 1920, inserting tubes near the sternum in the first, second and third intercostal
6 PARASTERNAL LYMPH NODE INVOLVEMENT IN NEOPLASTIC DISEASE 239 spaces following radical mastectomy. In 1947 RICHARD HANDLEY and A. C. THACK- RAY published an account of their first four cases of parasternal lymph node dissection in patients with carcinoma of the breast, in which they demonstrated lymph node involvement histologically. There followed a more detailed account of the internal mammary lymph node chain metastases in carcinoma of the breast by HANDLEY and THACKRAY in In 1948 MARGOTTINI was the first to develop a routine operative procedure for the removal of the internal mammary lymphatic chain en bloc as part of a radical mastectomy. His 1952 report on 227 patients operated on showed that internal mammary lymph node involvement had occurred without axillary metastases and with small tumours in 5%, with outer half tumours and axillary lymph node involvement in 27.7%, with inner half tumours with nodes involved in the axilla in 40.5%, and with tumours occupying most of the breast in over 50%. DAHL-IVERSEN had been writing about lymph node metastases from Table 2 Frequency of internal mammary lymph nodes STIBBE (1918) examined 60 subjects post-mortem. Average number per subject of parasternal nodes, right and left sides SOERENSEN (1951) examined 39 subjects post-mortem. Average number per subject of parasternal nodes, right and left sides URBAN (1959) dissected 150 parasternal regions in patients with breast tumours and found nodes in 1st intercostal space in 91 per cent. 2nd rd th th breast carcinoma - particularly in the supraclavicular fossa - since 1927, and in 1951 he and SOERENSEN published the results of their work on the frequency with which lymph nodes could be found in the parasternal region and on their involvement in tumour spread from the breast. SOERENSEN reported 39 post-mortem examinations in which he observed an average of 7 nodes per subject, 3.5 on each side, rather less than that found by STIBBE in 1918 (Table 2). Since then much surgical evidence has been produced to show the frequency with which the parasternal and axillary nodes are involved from tumours of the inner or outer half of the breast. This evidence is summarised in Fig. 4.
7 ~ D. W. SMITHERS AND P. RIGBY-JONES No nodes tnvolved Pararlernal and nd arillary nodes 1 INNER HALF OF BREAST including CENTRAL k%%ly HUTCHINSON (1953 ANDREASSEN el a1 HAAGENSEN and OKlD URBAN \I959 HANDLEY and THACKRAY ( , Masleoomy Mastectomy BlOpSy Martertomy Mastectomy 81 carer. 20 inner hall 100 carer. 37 inner hall 100 cases, 45 inner hall 300 cases, 239 inner hall 150 carer, 61 inner hall OUTER HALF OF BREAST HAAGENYN and OBElD ANDREASSEN el al HUTCHINSON (19531 HANDLEY and THACKRAY URBAN i19541,1954' Blopry Mailectomy Mastectomy Marlectomy Marteaorny 100 Case$, 100 carer. 81 cases. 150 cases. 300 <ares. 55 outer hall 63 ouler hall 61 outer hall 89 outer hall 61 outer hall S 40 F Fig. 4. Frequency of internal mammary node involvement in selected series of carcinoma of breast. Parasternal Lymph Nodes Observed Clinically This anatomical and histological demonstration of parasternal lymph nodes and their involvement in tumour spread has not been matched by clinical demonstration of visible or palpable nodes in this region. When small these nodes are not easily detected clinically, and if seen they may be dismissed as subcutaneous or sternal deposits. Since 1937 we have records of 65 patients with breast cancer in whom were detected visible or palpable parasternal lymph nodes, over half of these being prominent enough to photograph. This does not represent the total incidence of palpable nodes in this situation occurring in all patients attending this hospital; all we have done is to record these findings when we have ourselves observed them in the patients we have examined. The point we wish to make here is that clinical evidence of metastatic involvement of these nodes can frequently be found if it is looked for (Fig. 5).
8 PARASTERNAL LYMPH NODE INVOLVEMENT IN NEOPLASTIC DISEASE 24 1 Fig. 5. Parasternal node involvement in 3rd left intercostal space in a patient with an outer half tumour. The majority of these parasternal metastases were observed as the first sign of recurrence following radical mastectomy in patients who had not been irradiated. In our series only 4 out of 65 had clinical evidence of parasternal recurrence after receiving parasternal irradiation. These recurrences may be small and single (Fig. 6), large and single (Fig. 7), or multiple. In these 65 patients the primary tumour was situated in the inner half of the breast in 58 % and in the outer half in 23 %; in the other 19 % the site of the original tumour before operation was not clearly stated. In 45% of our cases there was microscopical evidence of involvement of the axillary nodes at the time of mastectomy; in 29 % there was none; and in 26 % no information concerning the state of the axillary lymph nodes was available. Table 3 shows the frequency with which the parasternal nodes were seen clinically to be involved in each intercostal space in the Royal Marsden Hospital series. The internal mammary lymph node chain on the opposite side to the primary tumour was involved in a few instances. The reasons for believing without histological confirmation that these swellings were due to deposits in lymph nodes and not to subcutaneous metastases are that they appeared without evidence of subcutaneous spread elsewhere, were found at the known lymph node sites, and responded well to treatment without further local signs of spread in most cases, although many patients died of distant metastases. The
9 242 D. W. SMITHERS AND P. RIGBY-JONES Fig. 6. Small right post-operative parasternal recurrence in an unirradiated patient. Fig. 7. Large left parasternal recurrence; (a) before treatment; (b) after treatment. Patient lived for 2 years after treatment and died with distant metastases.
10 PARASTERNAL LYMPH NODE INVOLVEMENT IN NEOPLASTIC DISEASE 243 Table 3 Instances of parasternal lymph node metastases from carcinom of the breast observed clinically at the Royal Marsden Hospital (Total number of patients: 65) Site of primary tumour: Inner half of breast: 38 (58%); Outer half of breast: 15 (23%); Not stated: 12 (19%) Parasternal Lymph Node Involvement I Intercostal Same side as Opposite side to space primary tumour primary tumour 1st 2nd 3rd 4th 5th Average duration from first treatment to parasternal recurrence: 3 years 7 months. Average duration from pasternal recurrence to death: 1 year 11 months. Number of patients still alive: 14. Longest survival since parasternal recurrence: 15 years. Among these 65 patients the axillary nodes were involved microscopically in 29 (45 %); axillary nodes were not involved microscopically in 19 (29 %); there was no information about axillary nodes in 17' (27 %). * 3 of these patients were not operated on. I main reasons for thinking that patients presenting with a metastasis in the sternum from carcinoma of the breast really have direct invasion from an involved parasternal node is that the erosion is regularly on the same side as the primary, occurs at levels at which parasternal nodes are commonly found (Fig. 8), and is more frequent and has a much better prognosis than solitary bony metastases elsewhere. One of our patients with clinically advanced carcinoma of the breast, extensive bilateral lymph node involvement and a large mass in the sternum has remained alive and well for 14 years following radiotherapy (SMITHERS, 1958). Of the 65 patients reported, 14 are still alive and well, having lived for periods varying from 15 years to a few months since the appearance of the parasternal recurrence; 42 % of the cases survived for more than two years after treatment for these recurrences. Parasternal lymph node metastases from primary carcinomas other than in the breast are not very often observed clinically. In view of the frequency with which epitrochlear nodes, for example, may be felt in cases of lymphoma, this is perhaps rather surprising. Nevertheless, these nodes are sometimes enlarged in Hodgkin's
11 244 D. W. SMITHERS AND P. RIGBY-JONES Fig. 8. Radiograph of sternum showing erosion by enlarged parasternal lymph node. Fig. 9. Right parasternal lymph node enlargement in a patient with Hodgkin s disease. Fig. 10. Parasternal lymph node metastasis in a patient with a hypernephroma.
12 PARASTERNAL LYMPH NODE INVOLVEMENT IN NEOPLASTIC DISEASE 245 Fig. 12. Left parasternal lymph node metastasis in a patient with carcinoma of the thymus (infra-red photograph). Fig. 1 I. (left) Parasternal lymph node metastasis in a patient with carcinoma of the bronchus. Fig. 13. Parasternal and infraclavicular lymph node metastases in a patient with carcinoma of the cervix uteri. Fig. 14. Parasternal lymph node metastasis in a patient with carcinoma of the parotid gland.
13 246 D. W. SMITHERS AND P. RIGBY-JONES disease (Fig. 9)*, though they may be inconspicuous and difficult to photograph. We have a Is0 observed them to be involved in patients with, respectively, a hypernephroma (Fig. lo), a carcinoma of the bronchus (Fig. 1 I), a carcinoma of the thymus (Fig. 12). a carcinoma of the cervix uteri (Fig. 13), and a carcinoma of the parotid gland (Fig. 14). SUMMARY Little mention has been made of clinically detectable metastatic involvement of parasternal lymph nodes since Sampson Handley s observations published in 1927, though much work has been done in confirming his findings histologically. An account of clinical involvement of parasternal lymph nodes in patients with carcinoma of the breast is given. It is suggested that a number of deposits in the sternum are due to direct extension to the bone from metastases in parasternal lymph nodes. The importance of parasternal lymph node irradiation in the treatment of breast neoplasms is stressed. A few cases are reported with involvement of parasternal lymph nodes from primary tumours at other sites than the breast. REFERENCES ANDREASSEN, M., DAHL-IVERSEN, E., and SBRENSEN, B.: Glandular Metastases in Carcinoma of the Breast. Results of a More Radical Operation. Lancet 1 (1954), 176. DAHL-IVERSEN, E. : Recherches sur les mttastases microscopiques des ganglions lymphatiques parasternaux dans le cancer du sein. (Recherches histologiques de 57 cas optres radicalement). J. internat. Chir. 11 (1951), 492. HAAGENSEN, C. D., and OBEID, S. J.: Biopsy of the Apex of the Axilla in Carcinoma of the Breast. Ann. Surg. 149 (1959), 149. HALSTED, W. S.: The Results of Radical Operations for the Cure of Cancer of the Breast. Ann. Surg. 46 (1907), 1. HANDLEY, W. S.: Cancer of the Breast and Its Treatment, pp London: John Murray for The Middlesex Hospital Press, HANDLEY, W. S.: (a) The Radium Treatment of Sternal Recurrences in Cancer of the Breast. Clinical J. 56 (1927), 73. (b) Parasternal Invasion of the Thorax in Breast Cancer and Its Suppression by the Use of Radium Tubes as an Operative Precaution. Surg. Gynec. & Obst. 45 (1927), 721. HANDLEY, W. S.: Sternal Secondary Deposit of Breast Cancer Treated by Radium Implantation. Patient Well Twenty-fours Years Later. Proc. R. SOC. Med. 43 (1950), 83. HANDLEY, R. S., and THACKRAY, A. C.: Invasion of the Internal Mammary Lymph Glands in Carcinoma of the Breast. Brit. J. Cancer 1 (1947), 15. HANDLEY, R. S., and THACKRAY, A. C.: The Internal Mammary Lymph Chain in Carcinoma of the Breast. Study of 50 Cases. Lancet 2 (1949), 276. HANDLEY, R. S., and THACKRAY, A. C.: Invasion of Internal Mammary Lymph Nodes in Carcinoma of the Breast. Brit. med. J. 1 (1954), 61. HUTCHINSON, W. B.: Intercostal Dissection and Radical Mastectomy. Arch. Surg. 66 (1953), 440. MARGOTTINI, M.: R&nt Developments in the Surgical Treatment of Breast Carcinoma. Acta Unio internat. contra Cancrum 8 (1952), 176. RIGBY-JONES, P. : The Influence of Various Factors on Metastases in Carcinoma of the Breast. Brit. J. Cancer 7 (1953), * We have recently seen another patient with parasternal lymph node involvement in Hodgkin s disease.
14 PARASTERNAL LYMPH NODE INVOLVEMENT IN NEOPLASTIC DISEASE 247 SMITHERS, D. W.: Cancer of the Breast. A Study of Short Survival in Early Cases and of Long Survival in Advanced Cases. Amer. J. Roentgenol. 80 (1958), 740. SOERENSEN, B. : Recherches sur la localisation des ganglions lymphatiques parasternaux par rapport aux espaces intercostaux. J. internat. Chir. 11 (1951), 501. STIBBE, E. P.: The Internal Mammary Lymphatic Glands. J. Anat. 52 (1918), 257. URBAN, J. A.: Clinical Experience and Results of Excision of the Internal Mammary Lymph Node Chain in Primary Operable Breast Cancer. Cancer 12 (1959), 14.
THE MANAGEMENT OF THE SWOLLEN ARM IN CARCINOMA OF THE BREAST
THE MANAGEMENT OF THE SWOLLEN ARM IN CARCINOMA OF THE BREAST NORMAN TREVES, M.D. The terms "brawny arm" and "lymphedema" have been given to the swollen arm which may complicate the inoperable, recurrent,
More informationDIAGNOSIS AND TREATMENT OB' LESIONS
DIAGNOSIS AND TREATMENT OB' LESIONS OF THE BREAST' STUART W. RARRINGTON, M.D. Division of Surgemj, The Mayo Clinic, Rorhrslcr, Minaesola The educational program which the American Medical Associiltion
More informationB number of patients who have received conventional
FULL THICKNESS CHEST WALL RESECTION FOR RECURRENT BREAST CARCINOMA INVOLVING THE BONY CHEST WALL JATIN P. SHAH, MD, AND JEROME A. URBAN, MD Solitary recurrent breast cancer involving the bony chest wall
More informationcame from a carcinoma and in 12 from a sarcoma. Ninety lesions were intrapulmonary and the as the chest wall and pleura. Details of the primary
Thorax 1982;37:366-370 Thoracic metastases MARY P SHEPHERD From the Thoracic Surgical Unit, Harefield Hospital, Harefield ABSTRACI One hundred and four patients are reviewed who were found to have thoracic
More informationBREAST CANCER SURGERY. Dr. John H. Donohue
Dr. John H. Donohue HISTORY References to breast surgery in ancient Egypt (ca 3000 BCE) Mastectomy described in numerous medieval texts Petit formulated organized approach in 18 th Century Improvements
More informationTHE PROGNOSIS OF CARCINOMA OF THE BREAST IN RELATION TO THE TYPE OF OPERATION PERFORMED.
PROGNOSIS OF CARCINOMA OF THE BREAST 7 I wish to express my thanks to the Director of the Pathological Department, Royal Cancer Hospital, for facilities to study the autopsy records of the hospital. REFERENCES.
More informationPrimary chondrosarcoma of lung
Thorax,(1970), 25, 366. Primary chondrosarcoma of lung G. M. REES Department of Surgery, Brompton Hospital, Lontdonl, S.W.3 A case of primary chondrosarcoma of the lung is described in a 64-year-old man.
More information5.1 Breast, Anatomy. 70
Chapter 5 Breast 5.1 Breast, Anatomy Breasts, also called Mamma are mammary glands, subcutaneously placed on the ventral side of the trunk in mammalian species, and develop for the sole purpose of secreting
More informationTagawa, Yutaka; Kawahara, Katsunobu. Citation Acta medica Nagasakiensia. 1991, 36
NAOSITE: Nagasaki University's Ac Title Author(s) Paget's Disease of the Female Breas Ayabe, Hiroyoshi; Hara, Shinsuke; T Tagawa, Yutaka; Kawahara, Katsunobu Citation Acta medica Nagasakiensia. 1991, 36
More informationProf. Dr. NAGUI M. ABDELWAHAB,M.D.; MARYSE Y. AWADALLAH, M.D. AYA M. BASSAM, Ms.C.
Role of Whole-body Diffusion MR in Detection of Metastatic lesions Prof. Dr. NAGUI M. ABDELWAHAB,M.D.; MARYSE Y. AWADALLAH, M.D. AYA M. BASSAM, Ms.C. Cancer is a potentially life-threatening disease,
More informationDISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV
DISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV NEOPLASMS A) Epithelial I. Benign Pleomorphic adenoma( Mixed tumour) Adenolymphoma (Warthin s tumour) Oxyphil adenoma (Oncocytoma)
More informationDebate Axillary dissection - con. Prof. Dr. Rodica Anghel Institute of Oncology Bucharest
Debate Axillary dissection - con Prof. Dr. Rodica Anghel Institute of Oncology Bucharest Summer School of Oncology, third edition Updated Oncology 2015: State of the Art News & Challenging Topics Bucharest,
More informationHIGH INCIDENCE OF BREAST CANCER IN THYROID
670 HIGH INCIDENCE OF BREAST CANCER IN THYROID CANCER PATIENTS L. J. CHALSTREY AND B. BENJAMIN* From the Royal Free Hospital, Gray's Inn Road, London, W.C.1, and the Division, Ministry of Health, Russell
More informationInes Buccimazza 16 TH UP CONTROVERSIES AND PROBLEMS IN SURGERY SYMPOSIUM
BILATERAL MASTECTOMY IS NOT ROUTINELY JUSTIFIED IN PATIENTS WITH BILATERAL AXILLARY LYMPHADENOPATHY AND ONLY ONE DETECTABLE PRIMARY BREAST CANCER LESION SURGERY SYMPOSIUM Ines Buccimazza Breast Unit Department
More informationMastectomy. Brought to you in association with EIDO Healthcare and endorsed by the Royal College of Surgeons England.
Mastectomy Brought to you in association with EIDO Healthcare and endorsed by the Royal College of Surgeons England. Discovery has made every effort to ensure that we obtained the information in this brochure
More informationExercise 15: CSv2 Data Item Coding Instructions ANSWERS
Exercise 15: CSv2 Data Item Coding Instructions ANSWERS CS Tumor Size Tumor size is the diameter of the tumor, not the depth or thickness of the tumor. Chest x-ray shows 3.5 cm mass; the pathology report
More informationTHE RESULTS OF SURGICAL TREATMENT IN NODULAR GOITRE
POSTGRAD. MED. J. (1966) 42, 490 THE RESULTS OF SURGICAL TREATMENT IN NODULAR GOITRE P. H. DICKINSON, M.B., B.S. (Durh.), M.S. (I11.), F.R.C.S. I. F. MCNEILL, M.S., F.R.C.S. Department of Surgery, Royal
More informationManagement of Neck Metastasis from Unknown Primary
Management of Neck Metastasis from Unknown Primary.. Definition Histologic evidence of malignancy in the cervical lymph node (s) with no apparent primary site of original tumour Diagnosis after a thorough
More informationNorthumbria Healthcare NHS Foundation Trust. Breast Sentinel Lymph Node Biopsy. Issued by the Breast Team
Northumbria Healthcare NHS Foundation Trust Breast Sentinel Lymph Node Biopsy Issued by the Breast Team Why do my Lymph Nodes require investigation? The lymphatic system is a pathway of lymph vessels and
More informationCOPE Library Sample
Breast Anatomy LOBULE LOBE ACINI (MILK PRODUCING UNITS) NIPPLE AREOLA COMPLEX ENLARGEMENT OF DUCT AND LOBE LOBULE SUPRACLAVICULAR NODES INFRACLAVICULAR NODES DUCT DUCT ACINI (MILK PRODUCING UNITS) 8420
More informationBreast Cancer. Most common cancer among women in the US. 2nd leading cause of death in women. Mortality rates though have declined
Breast Cancer Most common cancer among women in the US 2nd leading cause of death in women Mortality rates though have declined 1 in 8 women will develop breast cancer Breast Cancer Breast cancer increases
More informationBreast Cancer Staging
Breast Cancer Staging Symposium on Best Practice in Recording Cancer Stage Royal College of Pathologists 10 June 2011 Dr Gill Lawrence, Director Tel: 0121 415 8129 Fax: 0121 414 7712 Email: gill.lawrence@wmciu.nhs.uk
More informationSurgery for Breast Cancer
Surgery for Breast Cancer 1750 Mastectomy - Petit 1894 Radical mastectomy Halsted Extended, Super radical mastectomy 1948 Modified radical mastectomy Patey 1950-60 WLE & RT Baclesse, Mustakallio 1981-85
More informationACRIN 6666 Therapeutic Surgery Form
S1 ACRIN 6666 Therapeutic Surgery Form 6666 Instructions: Complete a separate S1 form for each separate area of each breast excised with the intent to treat a cancer (e.g. each lumpectomy or mastectomy).
More informationTable of contents. Page 2 of 40
Page 1 of 40 Table of contents Introduction... 4 1. Background Information... 6 1a: Referral source for the New Zealand episodes... 6 1b. Invasive and DCIS episodes by referral source... 7 1d. Age of the
More informationBreast Cancer. Saima Saeed MD
Breast Cancer Saima Saeed MD Breast Cancer Most common cancer among women in the US 2nd leading cause of death in women 1 in 8 women will develop breast cancer Incidence/mortality rates have declined Breast
More informationJournal of Breast Cancer
Journal of Breast Cancer ORIGINAL ARTICLE J Breast Cancer 2013 June; 16(2): 202-207 The Metastatic Rate of Internal Mammary Lymph Nodes When Metastasis of Internal Mammary Lymph Node Is Suspected on PET/CT
More informationAdvances in Breast Surgery. Catherine Campo, D.O. Breast Surgeon Meridian Health System April 17, 2015
Advances in Breast Surgery Catherine Campo, D.O. Breast Surgeon Meridian Health System April 17, 2015 Objectives Understand the surgical treatment of breast cancer Be able to determine when a lumpectomy
More informationRadiation-Induced Soft-Tissue Fibrosarcoma: Surgical Therapy and Salvage
Radiation-Induced Soft-Tissue Fibrosarcoma: Surgical Therapy and Salvage M. B. O Neil, Jr., M.D., William Cocke, M.D., Duncan Mason, M.D., and Edward J. Hurley, M.D. ABSTRACT Soft-tissue fibrosarcomas
More informationOutcomes of patients with inflammatory breast cancer treated by breast-conserving surgery
Breast Cancer Res Treat (2016) 160:387 391 DOI 10.1007/s10549-016-4017-3 EDITORIAL Outcomes of patients with inflammatory breast cancer treated by breast-conserving surgery Monika Brzezinska 1 Linda J.
More informationDirectly Coded Summary Stage Breast Cancer
1 Directly Coded Summary Stage Breast Cancer National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention and Control, Cancer Surveillance Branch For best viewing of
More informationThoracoscopic left upper lobectomy with systematic lymph nodes dissection under left pulmonary artery clamping
GCTAB Column Thoracoscopic left upper lobectomy with systematic lymph nodes dissection under left pulmonary artery clamping Yi-Nan Dong, Nan Sun, Yi Ren, Liang Zhang, Ji-Jia Li, Yong-Yu Liu Department
More informationSECONDARY DEPOSITS IN THE BREAST
738 SECONDARY DEPOSITS IN THE BREAST T. J. DEELEY From the Radiotherapy Department, Hammersmith Hospital, Du Cane Road, London, W.412 Received for publication June 4. 1965 PRIMARY malignant disease of
More informationCODING PRIMARY SITE. Nadya Dimitrova
CODING PRIMARY SITE Nadya Dimitrova OUTLINE What is coding and why do we need it? ICD-10 and ICD-O ICD-O-3 Topography coding rules ICD-O-3 online WHAT IS CODING AND WHY DO WE NEED IT? Coding: to assign
More informationSARCOMA ASSOCIATED WITH METASTASES FROM BREAST CARCINOMA
SARCOMA ASSOCIATED WITH METASTASES FROM BREAST CARCINOMA CHARLES W. LESTER, M.D. The association of two malignant tumors of an entirely different type in the same individual is sufficiently uncommon to
More informationCollaborative Stage for TNM 7 - Revised 12/02/2009 [ Schema ]
CS Tumor Size Collaborative Stage for TNM 7 - Revised 12/02/2009 [ Schema ] Note: the specific tumor size as documented in the medical record. If the ONLY information regarding tumor size is the physician's
More information2018 Summary Stage PEGGY ADAMO, RHIT, CTR OCTOBER 11, 2018
1 2018 Summary Stage PEGGY ADAMO, RHIT, CTR ADAMOM@MAIL.NIH.GOV OCTOBER 11, 2018 2 Acknowledgement Jennifer Ruhl, NCI SEER 3 Introduction 2018 SUMMARY STAGE 2018 Summary Stage 4 First update since 2001
More informationCANCER AND SURVIVAL RATE.
19 THE RELATION BETWEEN DELAY IN TREATMENT OF CANCER AND SURVIVAL RATE. W. L. HARNETT. From the British Empire Cancer Campaign, 11, Grosvenor Crescent, Hyde Park Corner, London, S. W. 1. Received for publication
More informationB02 Mastectomy. Expires end of November Write questions or notes here:
Practice Locations: St John of God Consulting Suites, 117 Anstruther Road, Mandurah Suite 50, Murdoch Medical Centre, 100 Murdoch Drive, Murdoch Tel: 08 6333 2800 Web: saudhamza.com.au B02 Mastectomy Expires
More informationThe breast advice for managing radiotherapy induced skin reactions
15/05/2016 The breast advice for managing radiotherapy induced skin reactions Margaret Hjorth Nurse Unit Manager Epworth Radiation Oncology 1 15/05/2016 What is Radiotherapy? Use of high energy radiation
More informationProcedure Information Guide
Procedure Information Guide Imaging-assisted wide local excision Brought to you in association with EIDO and endorsed by the The Royal College of Surgeons of England Discovery has made every effort to
More informationChapter 28. Breasts and Mammary Glands
Chapter 28 Breasts and Mammary Glands Breasts and Mammary Glands breast mound of tissue overlying the pectoralis major enlarges at puberty and remains so for life most of the time it contains very little
More informationClinical Outcome of Reconstruction With Tissue Expanders for Patients With Breast Cancer and Mastectomy
Clinical Outcome of Reconstruction With Tissue Expanders for Patients With Breast Cancer and Mastectomy Mitsui Memorial Hospital Department of Breast and Endocine surgery Daisuke Ota No financial support
More informationHodgkin s Disease of the Mediastinum
THE ANNALS OF THORACIC SURGERY Journal of The Society of Thoracic Surgeons and the Southern Thoracic Surgical Association VOLUME 3 NUMBER 4 APRIL 1967 Hodgkin s Disease of the Mediastinum William A. Burke,
More informationT of radiation treatment and surgical resection
BREAST CANCER-PREOPERATIVE AND POSTOPERATIVE RADIATION THERAPY WILLIAM E. POWERS, MD Our goal is to develop new methods of breast cancer treatment that produce results better than those usually obtained
More informationDepartment of Otolaryngology, Kurume University School of Medicine, Kurume, Japan
THE KURUME MEDICAL JOURNAL Vol. 16, No. 3, 1969 PATHOLOGICAL STUDIES RELATING TO NEOPLASMS OF THE HYPOPHARYNX AND THE CERVICAL ESOPHAGUS IKUICHIRO HIROTO, YASUSHI NOMURA, KUSUO SUEYOSHI, SHIGENOBU MITSUHASHI,
More informationTitle. CitationInternational Cancer Conference Journal, 4(1): Issue Date Doc URL. Rights. Type. File Information
Title Lymph node metastasis in the suprasternal space from Homma, Akihiro; Hatakeyama, Hiromitsu; Mizumachi, Ta Author(s) Tomohiro; Fukuda, Satoshi CitationInternational Cancer Conference Journal, 4(1):
More informationBasaloid carcinoma of the anal canal
J. clin. Path. (1967), 0, 18 Basaloid carcinoma of the anal canal LILLIAN S. C. PANG AND B. C. MORSON From the Research Department, St. Mark's Hospital, London SYNOPSIS The pathology and results of treatment
More informationManagement of the Axilla at Initial Surgery Manejo da Axila em Cirurgia Inicial
DISCIPLINA DE MASTOLOGIA ESCOLA PAULISTA DE MEDICINA UNIVERSIDADE FEDERAL DE SÃO PAULO Management of the Axilla at Initial Surgery Manejo da Axila em Cirurgia Inicial Disciplina de Mastologia Prof. Dr.
More informationClinical Pathological Conference. Malignant Melanoma of the Vulva
Clinical Pathological Conference Malignant Melanoma of the Vulva History F/48 Chinese Married Para 1 Presented in September 2004 Vulval mass for 2 months Associated with watery and blood stained discharge
More informationClinical Trials of Proton Therapy for Breast Cancer. Andrew L. Chang, MD 張維安 Study Chair
Clinical Trials of Proton Therapy for Breast Cancer Andrew L. Chang, MD 張維安 Study Chair AndrewLChangMD@gmail.com Disclosure Proton Center Development Corporation Scripps San Diego Proton Therapy Center
More informationMedical Education. CME Article Clinics in diagnostic imaging (125) Padungchaichote W, Kongmebhol P, Muttarak M
1062 Medical Education CME Article Clinics in diagnostic imaging (125) Padungchaichote W, Kongmebhol P, Muttarak M la Ib Ic Fig. I (a) Bilateral mediolateral oblique mammograms; (b) spot right craniocaudal
More informationEC.-i...:...~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Congenital malignant neurilemmoma. only instance of malignant neurilemmoma seen at
J. clin. Path. (1964), 17, 130 SYNOPSIS Congenital malignant neurilemmoma The late MARTIN BODIAN AND ANDREW W. WILKINSON From The Hospitalfor Sick Children, Great Ormond Street, London A unique case of
More informationSEER Summary Stage Still Here!
SEER Summary Stage Still Here! CCRA NORTHERN REGION STAGING SYMPOSIUM SEPTEMBER 20, 2017 SEER Summary Stage Timeframe: includes all information available through completion of surgery(ies) in the first
More informationVENOUS DRAINAGE O US F UPPER UPPER LIM B BY dr.fahad Ullah
VENOUS DRAINAGE OF UPPER LIMB BY dr.fahad Ullah Venous drainage of the supper limb The venous system of the upper limb drains deoxygenated blood from the arm, forearm and hand It can anatomically be divided
More informationThyroid INTRODUCTION ANATOMY SUMMARY OF CHANGES
AJC 7/14/06 1:19 PM Page 67 Thyroid C73.9 Thyroid gland SUMMARY OF CHANGES Tumor staging (T) has been revised and the categories redefined. T4 is now divided into T4a and T4b. Nodal staging (N) has been
More informationLIFE EXPECTANCY AND INCIDENCE OF MALIGNANT DISEASE
LIFE EXPECTANCY AND INCIDENCE OF MALIGNANT DISEASE IRA T. NATHANSON,' M.S., M.D., AND CLAUDE E. WELCH,2 M.A., M.D. (From the Collis P. Huntington Memorial Hospital, Harvard University, Boston, Mass., and
More informationLos Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010
Los Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010 Self Assessment Module on Nuclear Medicine and PET/CT Case Review FDG PET/CT IN LYMPHOMA AND MELANOMA Submitted
More informationWhat is Cancer? Petra Ketterl, MD Medical Oncology and Functional Medicine
What is Cancer? Petra Ketterl, MD Medical Oncology and Functional Medicine What is Cancer? Layman s terms: cancer starts when cells grow out of control (in any place in the body) and crowd out normal cells
More informationDiseases of the breast (2 of 2) Breast cancer
Diseases of the breast (2 of 2) Breast cancer Epidemiology & etiology The most common type of cancer & the 2 nd most common cause of cancer death in women 1 of 8 women in USA Affects 7% of women Peak at
More information3/23/2017. Disclosure of Relevant Financial Relationships. Pathologic Staging Updates in Breast Cancer. Pathologic Staging Updates Breast Cancer
Pathologic Staging Updates in Breast Cancer Disclosure of Relevant Financial Relationships USCAP requires that all planners (Education Committee) in a position to influence or control the content of CME
More informationSARCOMA FOLLOWING X-RAY THERAPY FOR GRAVES' DISEASE
SARCOMA FOLLOWING X-RAY THERAPY FOR GRAVES' DISEASE By P. H. JAYES, M.B., B.S., F.R.C.S., and R. H. DALE, M.B., B.Chir., F.R.C.S.Ed. From the Plastic Surgery and Jaw Injuries Centre, East Grinstead IT
More informationMuco-epidermoid tumours of the anal canal
J. clin. Path. (1963), 16, 200 Muco-epidermoid tumours of the anal canal B. C. MORSON AND H. VOLKSTADT From the Research Department, St. Mark's Hospital, London SYNOPSIS The pathology of 21 cases of muco-epidermoid
More informationSURVIVAL AFTER LUNG RESECTION FOR BRONCHIAL CARCINOMA
Thorax (1955), 10, 183. SURVIVAL AFTER LUNG RESECTION FOR BRONCHIAL CARCINOMA BY J. R. BIGNALL AND A. J. MOON From the Brompton Hospital, the London Chest Hospital, and the Institute of Diseases of the
More informationSTAGE CATEGORY DEFINITIONS
CLINICAL Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery TX Tis Tis (DCIS) Tis (LCIS) Tis (Paget s) T1 T1mi T1a T1b T1c a b c
More informationSo, we already talked about that recognition is the key to optimal treatment and outcome.
Hi, I m Dr. Anthony Lucci from the University of Texas MD Anderson Cancer Center in Houston. And today, I d like to talk to you about the role of surgery in inflammatory breast cancer patients. So, there
More informationBreast Surgery When Less is More and More is Less. E MacIntosh, MD June 6, 2015
Breast Surgery When Less is More and More is Less E MacIntosh, MD June 6, 2015 Presenter Disclosure Faculty: E. MacIntosh Relationships with commercial interests: None Mitigating Potential Bias Not applicable
More informationVagina. 1. Introduction. 1.1 General Information and Aetiology
Vagina 1. Introduction 1.1 General Information and Aetiology The vagina is part of internal female reproductive system. It is an elastic, muscular tube that connects the outside of the body to the cervix.
More informationCARCINOMA IN A RECONSTRUCTED (ESOPHAGUS. By PERCY H. JAYES, M.B., F.R.C.S. From The Queen Victoria Hospital, East Grinstead
CARCINOMA IN A RECONSTRUCTED (ESOPHAGUS By PERCY H. JAYES, M.B., F.R.C.S. From The Queen Victoria Hospital, East Grinstead THE purpose of this short paper is twofold: first, to report a condition which
More informationThe Alvin & Lois Lapidus Cancer Institute BREAST CANCER
The Alvin & Lois Lapidus Cancer Institute BREAST CANCER What is breast cancer? Breast cancer is a disease in which cancer cells form in the tissues of the breast. The breast is made up of lobes and ducts.
More informationJordan University Faculty Of Medicine. Breast. Dr. Ahmed Salman. Assistant professor of anatomy & embryology
Jordan University Faculty Of Medicine Breast Dr. Ahmed Salman Assistant professor of anatomy & embryology The breasts are specialized accessory glands of the skin that secretes milk. They are situated
More informationMUSCLE - INVASIVE AND METASTATIC BLADDER CANCER
10 MUSCLE - INVASIVE AND METASTATIC BLADDER CANCER Recommendations from the EAU Working Party on Muscle Invasive and Metastatic Bladder Cancer G. Jakse (chairman), F. Algaba, S. Fossa, A. Stenzl, C. Sternberg
More informationRadiation-induced Brachial Plexopathy: MR Imaging
Radiation-induced Brachial Plexopathy 85 Chapter 5 Radiation-induced Brachial Plexopathy: MR Imaging Neurological symptoms and signs of brachial plexopathy may develop in patients who have had radiation
More informationRadiology- Pathology Conference 4/29/2012. Lymph Nodes. John McGrath
Radiology- Pathology Conference 4/29/2012 Lymph Nodes John McGrath 1 Presentation material is for education purposes only. All rights reserved. 2012 URMC Radiology Page 1 of 24 Case 1: 51 year-old male
More informationCase Scenario 1. Pathology report Specimen from mediastinoscopy Final Diagnosis : Metastatic small cell carcinoma with residual lymphatic tissue
Case Scenario 1 Oncology Consult: Patient is a 51-year-old male with history of T4N3 squamous cell carcinoma of tonsil status post concurrent chemoradiation finished in October two years ago. He was hospitalized
More informationForgotten Volkmann Operation (Modified Radical Mastectomy) and its Value in Modern Combined Treatment of Breast Cancer
Research Open Cancer Studies and Therapeutics Volume 2 Issue 6 Research Article Forgotten Volkmann Operation (Modified Radical Mastectomy) and its Value in Modern Combined Treatment of Breast Cancer Valerijus
More informationManagement of recurrent phyllodes with full thickness chest wall resection
ORIGINAL ARTICLES Management of recurrent phyllodes with full thickness chest wall resection R Awwal a, SA Shashi b, MS Khondokar c, SH Khundkar d Abstract: Phyllodes tumours are biphasic fibroepithelial
More informationPaget's Disease of the Breast: Clinical Analysis of 45 Patients
236 Paget's Disease of the Breast: Clinical Analysis of 45 Patients Mingfian Yang Hao Long Jiehua He Xi Wang Zeming Xie Department of Thoracic Oncology, Cancer Center of Sun Yat-sen University, Guangzhou
More informationAdvances in Localized Breast Cancer
Advances in Localized Breast Cancer Melissa Camp, MD, MPH and Fariba Asrari, MD June 18, 2018 Moderated by Elissa Bantug 1 Advances in Surgery for Breast Cancer Melissa Camp, MD June 18, 2018 2 Historical
More informationInteractive Staging Bee
Interactive Staging Bee ROBIN BILLET, MA, CTR GA/SC REGIONAL CONFERENCE NOVEMBER 6, 2018? Clinical Staging includes any information obtained about the extent of cancer obtained before initiation of treatment
More informationPathology Report Patient Companion Guide
Pathology Report Patient Companion Guide Breast Cancer - Understanding Your Pathology Report Pathology Reports can be overwhelming. They contain scientific terms that are unfamiliar and might be a bit
More informationMALIGNANT TUMOURS OF THE JAWS
MALIGNANT TUMOURS OF THE JAWS MALIGNANT TUMOURS OF THE JAWS Squamous cell carcinoma Osteogenic sarcoma Chondrosarcoma Fibrosarcoma Malignant lymphomas (incl. Burkitt s) Multiple myeloma Ameloblastoma Secondary
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX Site Group: Gynecology Cervix Author: Dr. Stephane Laframboise 1. INTRODUCTION 3 2. PREVENTION 3 3. SCREENING AND
More informationCombined chemotherapy and Radiotherapy for Patients with Breast Cancer and Extensive Nodal Involvement.
Combined chemotherapy and Radiotherapy for Patients with Breast Cancer and Extensive Nodal Involvement. Ung O, Langlands A, Barraclough B, Boyages J. J Clin Oncology 13(2) : 435-443, Feb 1995 STUDY DESIGN
More informationPregnancy in the middle of adjuvant treatment of Her2 positive breast cancer
ESMO Preceptorship Programme ESMO Preceptorship ADOLESCENTS & YOUNG ADULTS MALIGNANCIES Lugano, Switzerland 11-12 May 2018 Petra Vuković, University Hospital for Tumors, University Hospital Center Sestre
More informationCase Scenario 1 History and Physical 3/15/13 Imaging Pathology
Case Scenario 1 History and Physical 3/15/13 The patient is an 84 year old white female who presented with an abnormal mammogram. The patient has a five year history of refractory anemia with ringed sideroblasts
More informationProposed All Wales Vulval Cancer Guidelines. Dr Amanda Tristram
Proposed All Wales Vulval Cancer Guidelines Dr Amanda Tristram Previous FIGO staging FIGO Stage Features TNM Ia Lesion confined to vulva with
More informationInvasive Papillary Breast Carcinoma
410 This is an Open Access article licensed under the terms of the Creative Commons Attribution- NonCommercial-NoDerivs 3.0 License (www.karger.com/oa-license), applicable to the online version of the
More informationCatholic University of Louvain, St - Luc University Hospital Head and Neck Oncology Programme. Anatomopathology. Pathology 1 Sept.
Anatomopathology Pathology 1 Anatomopathology Biopsies Frozen section Surgical specimen Peculiarities for various tumor site References Pathology 2 Biopsies Minimum data, which should be given by the pathologist
More informationTrends in cancer incidence in South East England Henrik Møller and all staff at the Thames Cancer Registry, King s College London
Trends in cancer incidence in South East England 1960-2009 Henrik Møller and all staff at the Thames Cancer Registry, King s College London 1 2 3 Analysts Vicki Coupland Ruth Jack Margreet Lüchtenborg
More informationGuideline for the Management of Vulval Cancer
Version History Guideline for the Management of Vulval Cancer Version Date Brief Summary of Change Issued 2.0 20.02.08 Endorsed by the Governance Committee 2.1 19.11.10 Circulated at NSSG meeting 2.2 13.04.11
More informationTHE RELATIVE INCIDENCE OF OOPHORECTOMY IN WOMEN WITH AND WITHOUT CARCINOMA OF THE BREAST'
THE RELATIVE INCIDENCE OF OOPHORECTOMY IN WOMEN WITH AND WITHOUT CARCINOMA OF THE BREAST' WALLACE E. HERRELL, M.D. (Fellow in Medicine, The Mayo Clinic, Rochester, Minnesota) In the past two decades numerous
More informationConservative Surgery and Radiation Stage I and II Breast Cancer
Conservative Surgery and Radiation Stage I and II Breast Cancer Variant 1: Premenopausal 41-year-old woman, 1.1-cm GII IDC, upper outer quadrant (UOQ), ER/PR ( ), HER2 ( ), primary excised with lumpectomy,
More informationin patients with breast cancer1
Journal of the Royal Society of Medicine Volume 73 September 1980 617 Physical test for distant metastases in patients with breast cancer1 R C Coombes PhD MRCP T J Powles PhD MRCP M Abbott SRN L De Rivas
More informationCopy Right- Hongqi ZHANG-Department of Anatomy-Fudan University. Systematic Anatomy
Systematic Anatomy Department of Anatomy,Histology & Embryology Shanghai Medical College,Fudan University Dr.Hongqi Zhang ( 张红旗 ) Email: Zhanghq58@126.com Office: Building 9,Room308, 54237151-9308 Mobile:13761809799
More informationUK CAA Oncology Certification Charts
UK CAA Oncology Certification Charts 1. Colorectal 2. Malignant Melanoma 3. Germ Cell Tumour of Testis 4. Renal Cell Carcinoma 5. Breast Carcinoma 6. Non-small Cell Lung Cancer Note: All Class 1 cases
More informationBreastScreen Aotearoa Annual Report 2015
BreastScreen Aotearoa Annual Report 2015 EARLY AND LOCALLY ADVANCED BREAST CANCER PATIENTS DIAGNOSED IN NEW ZEALAND IN 2015 Prepared for Ministry of Health, New Zealand Version 1.0 Date November 2017 Prepared
More informationBenefit of Internal Mammary Lymph Nodes Irradiation in Patients with Breast Cancer
Benefit of Internal Mammary Lymph Nodes Irradiation in Patients with Breast Cancer Amr El-Kashif, MD, Mohamed Abdelrahman, MD, Salah El-Mesidy, MD Department of Clinical Oncology, Faculty of Medicine,
More informationVascular Pattern in Tumours
Acta Radiologica ISSN: 0001-6926 (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/iaro20 Vascular Pattern in Tumours To cite this article: (1957) Vascular Pattern in Tumours, Acta Radiologica,
More information