Abstract
In an effort to detect occult metastases in women with “early” breast cancer and no evidence of metastatic disease by conventional criteria, 50 women with “early” breast cancer were subjected to a battery of tests that included skeletal scintiscanning, liver scintiscanning, and measurements of urinary hydroxyproline, serum alkaline phosphatase of bone origin, serum alkaline phosphatase of liver origin and serum gamma glutamyl transpeptidase. One or more abnormalities suggestive of occult metastatic disease in the skeleton and/or the liver were found in 44% of patients. There was no correlation between positive test results and the finding of positive pectoral lymph nodes (found in 42% of patients). Short-term follow-up suggests a correlation between positive test results and development of recurrent disease. It appears that the performance of these tests preoperatively and the histological evaluation of pectoral and axillary lymph nodes are complementary approaches to the staging of breast cancer.
Résumé
Ce travail a pour but la détection des métastases occultes chez les femmes porteuses d'un cancer du sein “débutant” sans signe de dissémination. Cinquante malades ont été soumises à une batterie d'examens comprenant la scintigraphie osseuse et hépatique, la mesure de l'excrétion urinaire d'hydroxyproline, la détermination du taux sérique des phosphatases alcalines d'origine hépatique et osseuse ainsi que du taux sérique de la gamma-glutamyl-transpeptidase. Chez 44% des malades, nous avons trouvé une ou plusieurs anomalies suggérant des métastases occultes squelettiques et/ou hépatiques. Il n'y avait pas de corrélation entre la positivité de ces tests et l'envahissement néoplasique des ganglions pectoraux (trouvé dans 42% des cas). Quoique la période d'observation soit courte, il semble exister une corrélation entre la positivité des tests et la récidive de la maladie. Ces examens préopératoires et l'étude histologique des ganglions pectoraux et axillaires permettent de préciser le stade de la maladie.
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Cant, E.L., Smith, A.F., Sumerling, M.D. et al. “Superstaging” in breast cancer—A correlation of lymph node histology and investigations designed to detect occult metastatic disease. World J. Surg. 1, 303–305 (1977). https://doi.org/10.1007/BF01556843
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DOI: https://doi.org/10.1007/BF01556843