This study reports on 110 consecutive patients, mean age 59 years, operated on for partial mastectomy and axillary dissection. Radiotherapy of 50 Gy was administered to 75 of the patients. Most tumours were T1 tumours and all patients were NO. Lymphoedema is defined as an increase in arm volume > 10% and impaired shoulder mobility as an impairment of 15 degrees compared with the preoperative value. After operation, 21 patients developed lymphoedema, 17 in the radiotherapy group and 4 in the group without radiotherapy; 49% of the patients had reduced shoulder mobility, and of these, 57% were in the radiotherapy group and 30% in the group without radiotherapy. We found a good correlation between the number of patients stating arm swelling and patients with registered lymphoedema. There were fewer patients stating limitation of movement than patients with registered impaired mobility; 31% of patients were still perceiving some pain five years after the operation. We conclude, that breast-conserving therapy in breast cancer is afflicted with a significant arm morbidity that persists for several years after surgery.

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Dans cette analyse, nous estimons l’effet dynamique d’une hausse du taux d’imposition des hauts revenus sur les recettes fiscales au Québec. Depuis 10 ans, l’imposition des hauts revenus a augmenté considérablement au Québec, avec deux hausses successives en 2013 et 2016. Nous utilisons des microdonnées longitudinales provenant d’un grand échantillon de contribuables. Les effets obtenus par l’estimation suggèrent qu’une taxation accrue des hauts revenus ne permet pas à court terme de récolter davantage de recettes afin de poursuivre des objectifs de redistribution. Les effets à long terme sont plus positifs. Nous discutons également des mécanismes qui mènent à cette réponse dynamique.

No abstract