Breast carcinoma arising within fibroadenomas. Report of four observations

BACKGROUND

Fibroadenoma is a frequent benign breast tumor affecting young woman. The incidence of a carcinoma within adenofibromas is estimated at 0.1 to 0.3%.

AIM

The purpose of this study was to evaluate the outcome of patients with breast carcinoma arising within adenofibroma and to determine the clinical characteristics and the prognosis of this rare entity.

OBSERVATIONS

We retrospectively report on four cases of carcinomas arising in mammary fibroadenomas. The mean age was 41 years (26-53). In two cases, fibroadenomas was complex, containing cysts, adenosis and apocrine metaplasia. The adjacent parenchyma contained fibrocystic dystrophy lesions associated in one case to intralobular neoplasia lesions. The treatment consisted of a conservative treatment in two cases and a mastectomy plus axillary node dissection in the two others. Radiotherapy was indicated in all cases and chemotherapy done in three cases. All patients are alive with a mean follow up of 4.25 years (3-7) without any sign of recurrence.

CONCLUSION

Every benign mammary nodule must necessarily be verified surgically to avoid misdiagnosing any carcinomatous area because at this stage its prognosis is better.

[Place of the sulprostone in therapeutic interruptions of the pregnancy]

BACKGROUND

Therapeutic interruption of the pregnancies of the 2nd and 3-rd quarter is often badly accepted by the patients and it is original that his realization is easy, effective and the less traumatic possible. In this indication, the sulprostone (Nalador) is a big contribution.

AIM

The purpose of our study is to review this product, to describe our experience concerning its use in the therapeutic interruptions of pregnancies and to study alternatives in case of failure or of against indication in its use.

METHODS

It is about a forward-looking study opened from the 01-07-02 led in the service "A" of the CMNT. We brought together 30 women where a therapeutic interruption of the pregnancy was put and who did'nt present of against indications to the sulprostone.

RESULTS

The average age was of 27 years with extremes from 18 to 39 years 50% of our patients were nullipares. The terms of pregnancy varied from 16 to 28 LIMITED COMPANIES with an average of 20 LIMITED COMPANIES. The indications of these terminations of pregnancy were maternal in 33.33% of cases and foetal in 66.66% of cases. The average number of light bulbs of Nalador used by the women was of 2.25 with extremes going from 1 to 4. The delay of eviction from the beginning of the induction was on average of 21 hours, with a rate of success of 90%. We did not regret any break uterine Delivery was incomplete requiring a uterine revision under general anesthetic in 5 cases. Tolerance was good in general In case of failure alternatives were: the misoprostol (cytotec *), the Probe extra amniotic dries and the wet Probe.

CONCLUSION

The sulprostone by intravenous way constitutes an effective method of medical interruption of the pregnancy in the 2-nd and 3-rd quarter with a satisfactory tolerance and a rate of success of 90 %.