[Ulcerated cancers of the breast: results of modified mastectomy. Apropos of 64 cases]. / Les cancers ulcérés du sein: résultats des mastectomies de propreté. A propos de 64 observations.

Although, happily, at the present time the actual tendency in mammary neoplastic disease is being increasingly orientated towards conservative treatment, a fairly large number of total mastectomies are still being performed in patients diagnosed at a late stage. The frequency, technical aspects and precise local and general prognosis of this affection are discussed in relation to 63 breast cancers treated surgically between 1975 and 1984. These so-called "trimming" mastectomies represent 4.22% of overall total mastectomies performed during the same period. The surgical technic employed was the Patey type total mastectomy with either primary suturing after-wide separation of borders or closure with a thoraco-epigastric fasciocutaneous flap with internal pedicle. Actuarial survival was satisfactory: 58% at 2 years, 34% at 5 years, survival being significantly better in patients with lack of glandular invasion. This surgical technic should be considered, in combination with other therapy, for these patients, who should not be classed as "unrecoverable".

[Assessment of the inflammatory evolution of the sequelae of salpingitis]. / Appréciation de l'évolutivité inflammatoire des séquelles de salpingites.

Fifty-four patients who had consulted because of their sterility had a laparoscopy carried out with bacteriological, cytological and biochemical studies of the peritoneal fluid as well as a histological assessment of the peritoneal adhesions. The purpose of this prospective study was to show the usefulness of laparoscopy in pre-operative assessment of tubal sterility and to look for objective criteria of the progress of inflammation. To do the study, two groups of women in different clinical stages (29 patients with no pelvic infection and 25 patients who had salpingitis) were divided into three sub-groups: 25 free of disease, 4 subsiding salpingitis patients and 25 with tubo-peritoneal sequellae. Different samples taken with the laparoscope made it possible to decide whether the inflammatory process was carrying on or not in these 25 cases. Using swabs for bacteriological examinations we had to employ transport medium and this showed bacteria in 7 cases. We found a significant correlation between the serum and peritoneal levels of anti chlamydia antibodies and the levels of AC antibodies when there was a tubal lesion. There was little value in carrying out cytology on the peritoneal fluid except when the histology showed that this was necessary. The level of serum and peritoneal orosomucoid was found to be different in the two groups of patients. This study shows that it is necessary to assess several different parameters to exclude pelvic inflammatory disease before resorting to reparative tubal surgery.