For evaluation of clinical features and state of the art in the treatment of breast cancer in Iran, we studied 347 consecutive patients among 1123 hospital admissions (in 14 hospitals in three cities) who had undergone surgery for a mass in their breasts during a 2-year period, 1991 to 1992. Thirty-nine additional patients with breast cancer had been treated in the second year of the study, an increment of 8.9%. The relative frequency of positive biopsies for breast cancer was 31% for the entire series. In Teheran, Babol and Yazd, it was 35%, 24.2% and 18.1%, respectively. The mean age for the entire series was 48 +/- 1 years. The mean age for patients from Yazd was 51 +/- 9, which was higher than the mean age (41.5 +/- 16) of patients from Babol. The pathologic diameter was > 2.1 cm (pT2 and pT3) in 59.36% of the tumors. In 15.56% of the patients, the exact size of the tumor was not available. In 83.45% of the patients, the tumors were reported as infiltrating ductal carcinoma. Of 173 patients in whom regional nodes had been histologically examined, 80% had metastatic involvement (stage II disease). Modified radical mastectomy had been used more than radical mastectomy in this series, but the choice of the operation was not related to the size of tumor.
Lung metastases, which are an expression of the new phase of the underlying neoplastic disorder, have been treated in the recent years by multiple disciplinary approach. When the metastases to the lungs are multiple, it is indicative of extensive tumor burden, and the organ plays an insignificant role in the distribution of the metastases in the different lobes of the lungs. However, when the pulmonary metastases appear after a prolonged disease-free interval it becomes an enigma; when the metastases are solitary, the majority (over 80% in this series) are located in the upper zone of the lungs. This study of 28 patients with solitary lung metastases explores the possible etiology of this clinical observation and proposes that the pattern of perfusion and anatomopathological features of the upper lobes are the main reasons why these lobes are prevalently the sites for solitary lung metastases.~~
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