Gemcitabine was found to be effective in achieving stabilization and even a minimal response of soft tissue or bone sarcoma refractory to standard chemotherapy.

No abstract

Seven cases of soft tissue sarcoma developing after primary or postoperative radiotherapy for breast carcinoma are reported. The sarcomas occurred within the irradiated volume, after a latent period of 4-26 years. These cases conform well to established criteria for the diagnosis of radiation-induced sarcoma. Chemotherapy, consisting of the four-drug combination CYVADIC (cyclophosphamide, vincristine, adriamycin, DTIC) was employed in six of the seven patients. Only two of them achieved partial remission, lasting only 2 and 3 months, respectively. The effectiveness of adriamycin-containing chemotherapy regimens in soft tissue sarcomas as well as the remote hazard of radiation-related sarcoma in primary or postoperative breast irradiation are discussed.

A total of 2299 new cancer patients were referred to the Northern Israel Oncology Center in 1974 and in 1980. The stage of disease, delay in diagnosis, the responsibility for the delay, and the survival of those referred in 1974 were investigated. At the time of diagnosis, 39% of the patients had localized disease, 34% had locally advanced disease, and 23% had metastatic disease. In 52% of the patients there was no delay in diagnosis. No correlation was found in the group as a whole between the stage of disease and delay in diagnosis. Only in the breast cancer group without delay in diagnosis, however, were there significantly more patients at an early stage than at an advanced stage of disease. At each stage of disease, responsibility for the delay was shared about equally between the patients and the physicians, except in advanced breast cancer, where the patients were more often responsible for the delay. The survival rate was higher in patients in whom the disease was diagnosed earlier. It was also higher at each clinical stage (Stages I and II) in patients who had no delay than in those with delay in diagnosis. The survival rate was higher in patients who were themselves responsible for the delay in diagnosis than in patients whose physicians were responsible for the delay. In 1980, less diagnoses were delayed in fewer patients than in 1974 (42% versus 65%). Responsibility for the delay in 1980 lay equally with the patients and with the physicians, but when compared to 1974, the physicians' responsibility and administrative delay were less. Campaigns for early diagnosis are advocated.

Benign and/or malignant lesions may occur in surgical scars after mastectomy or lumpectomy (SML) in patients with breast cancer (BC). Early diagnosis of these lesions is essential for both therapeutic and prognostic evaluation. The diagnostic value of fine‐needle aspiration (FNA) was determined for these scar lesions. The findings of cytologic and histologic specimens obtained from the same lesion of SML in 83 women with BC were correlated. Twenty‐five FNA yielded only acellular specimens. Of the FNA done by the cytopathologist, only 6.2% were not representative. However, 45% of those done by less experienced clinicians were not representative. Representative FNA were obtained from 58 of the women who took part in the study. Based on the histologic diagnosis, 38 patients had malignant scar lesions (MSL), and 20 had benign scar lesions (BSL). In one patient of the 38 with MSL, cytologic examination did not show the malignant lesion; in four women, the tumor was suspected cytologically; and in the remaining 33, the cytologic findings were consistent with malignancy. In 18 of the 20 patients with BSL, cytologic findings were reported as benign and in the other two, as inconclusive. The sensitivity, specificity, and positive and negative predictive values for the cytologic findings were 97.4%, 100%, 100%, and 94.7%, respectively. The diagnostic accuracy of FNA cytology was 98.2%. No complications followed the procedure. It was concluded that FNA cytologic examination of lesions in SML is a simple, safe, highly accurate, and cost‐effective method to distinguish malignant from benign lesions in women with BC. Lesions in SML should be explored routinely by FNA, rather than by the traditional biopsy, provided the FNA is done by an experienced operator.