Abstract:

The sharing of expensive minimally-invasive breast biopsy technology is now allowing women in small cities and towns in the United States to receive the same quality of care as their counterparts living near major medical centers. By placing digital stereotactic and ultrasound systems in mobile coaches, entrepreneurs have filled a niche in the healthcare system which affects the lives of hundreds of thousands of women yearly.

Authors:

Charles M. Elboim, M.D., F.A.C.S. - Sonoma Valley Hospital, Sonoma, Calif.

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Abstract:

With the advent of advanced thoracoscopic techniques, new applications have been expanding their roles in thoracic surgery. The aim of this paper is to introduce our new thoracoscopic approach in performing parasternal lymph node dissection of advanced breast cancer for its staging. This technique does not need the removal of any costal cartilage which is usually done in the conventional classical technique after radical mastectomy. Thoracoscopic procedure, in which wide and complete parasternal lymph node dissection is done, is minimally invasive and easy to perform. Therefore, the thoracoscopic technique may be a suitable alternative to the conventional approach in the future.

Authors:

Akinori Akashi, M.D.; Shuichi Ohashi, M.D.; Takeshi Oriyama, M.D.; Hiroki Kanno, M.D.; Hideaki Sasaoka, M.D.; Masayuki Nishino, M.D.; Yasushi Sakamaki, M.D.; Gakuhei Son, M.D.; Manzurul Haque, M.D. - Takarazuka City Hospital, Hyogo, Japan

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Abstract:

For centuries, clinicians have recognized that a segment of their patient population is at increased risk to develop breast cancer based on their family history of the disease. Due to the absence of molecular information, it was not uncommon for women and their surgeons to make decisions regarding management of prophylactic surgery based solely on their family history, without specific information about the patient's personal risk to develop the disease. It has been only within the past 7 years that linkage for the breast cancer (BRCA) susceptibility genes has been established, and within the past 3 years that the genes have been cloned. Although clinical testing for the BRCA genes has been available for less than 2 years, it is already apparent that the implications for surgeons and their patients are significant.

Authors:

Ellen T. Matloff, M.S.; Beth N. Peshkin, M.S. - Georgetown University Medical Center, Washington, D.C.; Barbara A. Ward, M.D. - Yale University School of Medicine, New Haven, Conn.

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Abstract:

Colorectal cancer is the second leading cause of cancer-related deaths in men and women in the United States. In 1997, it is estimated that 131,200 new cases of colorectal cancer will be diagnosed and 54,900 deaths will occur due to the disease. Although the tumor is localized at the time of diagnosis and resection with curative intent is possible in approximately 75% of patients, more than a third will develop disease recurrence. Consequently, almost half of all patients with colorectal cancer will die of metastatic disease.

Authors:

Edith Peterson Mitchell, M.D., F.A.C.P. - Gastrointestinal Oncology, Philadelphia, Pa.

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