Comparative study of mammmary exploration methods.

The diagnostic value of physical examination, thermography and mastography was assessed in 1,313 women attending the Breast Cancer Detection Service of the Hospital de Oncología, C.M.N. The evaluation of results was based upon the estimation of sensitivity, specificity and predictive value of each examination, as well as, the combined sequential programme. Mastography showed the highest sensitivity with good specificity, therefore making it possible to use mastography as the only examination procedure in early detection programmes for breast cancer. Thermography was less sensitive so that it is not recommended as basic examination technique, although it can be included in multiple examination programmes or for the follow-up of high risk cases. Physical examination by a physician is essential for the integral diagnosis of breast pathology. The best results are obtained by sequential combination of the three examination techniques.

Burkitt's lymphoma. Experience at the Instituto Nacional de Pediatria, Mexico City.

Thirty patients with Burkitt's lymphoma sporadic type are presented. All of these cases fulfilled the histologic criteria of Burkitt's tumor. The age ranged from 2 to 12 years, with a median of 4 years. Fever and chills were the most common symptoms. The abdomen was the site of initial presentation in more than half of these cases. Close to one-third of the patients had involvement of the central nervous system. Fifty percent of the patients presented with lactic dehydrogenase elevation. Uric acid was elevated in close to one-fourth of these patients. The sonogram was the most useful technique in those instances of abdominal presentation. All patients were staged according to Ziegler criteria after an initial surgical diagnostic procedure was performed. None of the patients received radiotherapy to the primary tumor. All were submitted to a chemotherapy program for 12 months. Only 26 fitted the criteria of being evaluable. The duration of remission was from 1 to 144 months, with a median of 18.2 months. The actuarial survival was 84% at 3 years. Most of the responders corresponded to Stages A, B, and AR, while Stages C and D had a high mortality rate with elevated lactic dehydrogenase and uric acid levels.

Treatment of non-Hodgkin's lymphoma in Mexican children. The effectiveness of chemotherapy during malnutrition.

The histological diagnosis of non-Hodgkin's lymphoma (Burkitt's lymphoma excluded) in 147 children was reviewed. The most common site of presentation was in the abdomen (32.6%). The most frequent site of metastatic disease at diagnosis was the bone marrow (27.2%). The most common histology was diffuse undifferentiated non-Burkitt type (37.4%). According to the Murphy staging system, 40.1% were stage III and 27.2% were stage IV. In a nonrandomized prospective study, 121 patients were submitted to a treatment regimen (protocol 8001) and compared with 26 historical controls treated with the COP regimen, consisting of cyclophosphamide, vincristine, and prednisone. Of those patients treated with protocol 8001, nine had intestinal perforation at the site of primary disease. All patients in this group were malnourished at the time of perforation. The overall rate of initial complete remission in those patients treated with protocol 8001 was 90.7%. The duration of remission was from 16 to 108 months, with a median of 39 months. The actuarial rate of disease-free survival was 69% at 2 years and 63% at 6 years, compared with 36% at 6 years of the control group (COP) (p less than 0.01). None of the patients have relapsed after 4 years.