Palliative Radiotherapy as a Treatment for Carcinoma Invasion of the Sacrum: An Observational Case Series Study

Abstract

Background/Aim: Radiotherapy for carcinoma invasion of the sacrum (CIS) is an alternative treatment to surgery in patients with advanced, inoperable tumors or those not medically eligible for resection of the neoplasm. Herein we present an observational study of patients with imagingconfirmed CIS who were treated non-operatively with radiation. Patients and Methods: A retrospective chart review of CIS patients treated with palliative radiotherapy (PR) during a 9-year period (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) was performed. Results: Six women and 13 men with an average age of 60 years took part in this study. Most patients (84%) exhibited extrasacral metastases. Primary tumors included lung (n=6), colorectal (n=6), breast (n=3), bladder or kidney (n=2), and liver carcinoma or a tumor in an unknown primary site (n=2). The mean follow-up time was 10 months with a 2-year survival rate of 9%. The majority (71%) of symptomatic patients obtained relief from pain following PR. Half of those individuals who were non-ambulatory prior to therapy regained mobility. There were no acute ill-effects or later complications after irradiation. Conclusion: Despite the small cohort and poor overall survival rate, non-operative radiation treatment is a beneficial method of palliative care in patients with CIS.

Carcinoma of the axillary tail of Spence: A rare case report

“…Carcinoma of the axillary tail of Spence (CATS) has a reported incidence of 0.3 % [ 2 ]. The axillary tail of Spence (ATS) is considered a narrow extension of the upper quadrant of breast tissue that enters the axilla through a defect in the clavipectoral fascia, known as the foramen of Langer [ 4 ]. The axilla is also a common location for ectopic breast tissue, which is residual breast tissue that persists from normal embryologic development and is found in up to 6 % of the population [ 5 ].…”

“…CATS is commonly found in patients over the age of 45 years. It is usually detected in the early stages and is characterized by a lack of hormone receptors [ 4 , 7 , 8 ]. Compared to upper outer quadrant (UOQ) breast cancer, CATS has a higher grade, a higher rate of negative hormone receptors, and a greater tendency to spread to the lymph nodes, leading to a poorer prognosis [ 9 ].…”

“…The management of CATS comprises of a multi-disciplinary approach. The best approach is to follow the recommendations for histologically similar breast cancers of the same disease stage [ 4 ]. Patients with locally advanced breast cancer, positive axillary lymph nodes, and high-risk triple-negative or Her2Neu overexpressing tumors are offered neoadjuvant therapy [ 14 ].…”

A Simple Clinical Instrument to Predict the Survival Probability of Breast Cancer Patients Receiving Radiotherapy for Bone Metastases

“…During recent years, several studies have been carried out to improve the outcomes of patients with metastatic breast cancer (20)(21)(22)(23)(24). For patients with breast cancer who require irradiation for bone metastases, a variety of dose-fractionation regimens are available (1).…”

There is No “Axillary Tail”: Rethinking the Assumption of James Spence

“…6 Despite the recent movement to de-eponymize medicine, 7 the “axillary tail of Spence” remains in use, likely because of its presumed relevance in the management of breast cancers. 8,9 However, we believe there is inadequate data in either the original anecdotal mention, in contemporaneous written accounts, or in the more recent described variations to support that the “tail of Spence” exists at all, let alone that it represents normal human anatomy.…”