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offered in early breast cancer then it becomes of paramount importance to consider the psychological impact of treatment to be offered.The degree of psychosocial morbidity among the patients treated by local excision and radiotherapy was a disappointing finding, but one which cannot be ignored. These women clearly need just as much counselling support as patients who undergo mastectomy.As more surgeons start to advocate breast conservation it is important that we have more basic research into the causal factors of the psychiatric morbidity experienced by women who receive this

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The pharmacological disposition of the anthracenedione mitozantrone has been measured in 11 patients with six different tumour types. Administered at 14 mg/m2 as a 30-min infusion, the drug was assayed by a high-pressure liquid chromatographic technique sensitive to 1 ng mitozantrone/ml plasma. The mean half-lives for mitozantrone in plasma were as follows: alpha, 9.4 min; beta, 1.6 h; gamma, 23 h. The mean volume of distribution (Vd) was 1565 l. For two patients with impaired liver function the T1/2 gamma and Vd were 63.1 h and 4853 l, respectively. Less than 5% of the administered drug was excreted in urine, but two urinary metabolites were identified. These were not influenced by pre incubation of urine samples with beta-glucuronidase or sulphatase, suggesting that neither metabolite is a glucuronide or a sulphate conjugate of mitozantrone. Hepatic metabolism is the major route of elimination of mitozantrone, and caution should be exercised when using this drug for patients with hepatic dysfunction.

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