[Results of the conservative surgical and irradiation treatment of 132 nonpalpable ductal carcinomas in situ of the breast]. / Résultats du traitement par chirurgie conservatrice et irradiation de 132 carcinomes canalaires in situ non palpables du sein.

PURPOSE: Retrospective analysis of results of treatment of 132 subclinical ductal carcinomas in situ, non-palpable. MATERIAL AND METHODS: Patients were treated with limited surgery and 70 Gy radiation therapy (70 Gy). RESULTS: With a median follow-up of 7 years, the total recurrence rate was 6%, and the actuarial rate at 5 years 4% and at 10 years 13% at. These have no influence on recurrence on the specific actuarial survival rate which was 100% at 10 years. In spite of five infiltrating recurrences of seven, no metastasis appeared 48 months after the salvage surgery. The global rate of breast preservation was 92% at 7 years. DISCUSSION AND CONCLUSION: Therapeutic indications were developed taking into account the present analysis and a literature review (2,338 in situ ductal carcinomas, palpable or not, treated with conservative surgery, with or without adjuvant radio-therapy).

[Calcified splenic abscess, colonic fistula and ascites in a chronic carrier of Salmonella typhi]. / Abcès splénique calcifié, fistule colique et ascite chez un porteur chronique de Salmonella typhi.

We report the unusual case of a patient with chronic carriage of Salmonella typhi who presented with partially calcified splenic abscess linked to colic fistula and ascitis. The colic fistula could be secondary to ischemic necrosis by left colon compression due to spleen large abscess. Fistula was evidenced by abdominal computed tomography scan and confirmed by barium enema. The possible etiologies of ascitis are either tuberculosis or ascitic peritonitis secondary to the fistulisation; nevertheless, the role of segmentary portal located hypertension cannot be completely excluded. The splenic abscess was probably due to Salmonella typhi which was only isolated from stool specimens. The calcified splenic abscess was the evidence that the infection had occurred first. In addition, the isolation of Salmonella typhi in stool cultures six months after the subject had returned from the Comores proved the chronic carriage. Treatment by splenectomy and left colectomy was successful in this patient.

[Conservative treatment of sub-clinical noninfiltrating cancers of the breast (102 EOA in situ, TONO)]. / Le traitement conservateur des cancers du sein infra-cliniques canalaires non infiltrants (102 EOA in situ, TONO).

102 patients with sub-clinical intra ductal non invasive breast cancer (T0N0) treated by limited surgery and curative radiation therapy. Follow-up ranged from 2 to 10 years with a median follow-up of 59 months. The long term survival rate of this therapeutic approach, consisting of simple excision without any adjuvant treatment and radical mastectomy was close to 100%. The actuarial local recurrence rate was only 8.6% at 10 years (confidence interval: 4.6 to 12.6%), which strongly suggests that radiation therapy is active on multicentric foci. Salvage surgery could be performed in every case of local recurrence. The survival rate of in situ breast cancer (T0N0) treated by conservative radio-surgery is comparable to that of radical mastectomy, while cosmetic results and psychological impact appear to be better for the conservative technique (breast preservation rate = 91 to 96%).