Stage Ⅳ breast cancer refers to breast cancer that has already metastasized to distant regions when initially diagnosed. Treatment for stage Ⅳ is intended to "prolong survival and palliate symptoms". Resec...Stage Ⅳ breast cancer refers to breast cancer that has already metastasized to distant regions when initially diagnosed. Treatment for stage Ⅳ is intended to "prolong survival and palliate symptoms". Resection of a primary tumor is considered to be "effective only at alleviating chest symptoms and providing local control" in spite of the advances of imaging examination and medication for breast cancer. Molecular target and endocrine drugs are very effective and useful to tailor-make a treatment strategy according to breast cancer subtypes. Positron emission tomography-computed tomography can detect and diagnose the very small metastases and recurrences which can potentially be cured even if they are distant metastases. Recently, many retrospective studies have reported the survival benefit of surgery for breast cancer patients with metastases and some clinical trials which confirm the surgical prognostic benefit for them have started to enrol patients. The goal of treatment has to be clearly identified:increase the patient's survival time, provide local control or perform histology to determine the cancer's properties. The best evidence is absolutely essential to treat patients who need surgery at the right time. We need to evaluate the treatment strategy, including primary resection for stage Ⅳ breastcancer particularly, and find new evidence by prospective analysis.展开更多
Hereby we describe a case of LAF developed after a surgical Maze procedure that demonstrates the importance of a systematic approach to mapping and ablating atypical atrial flutter to prevent a recurrence of symptomat...Hereby we describe a case of LAF developed after a surgical Maze procedure that demonstrates the importance of a systematic approach to mapping and ablating atypical atrial flutter to prevent a recurrence of symptomatic arrhythmia. In patients with previous cardiac surgery procedures, and in particular after a surgical maze, there are many different potential LA reentry circuits that involve various pathways. Both activation mapping and entrainment mapping were performed in order to identify the critical isthmus of the circuit and to effectively terminate the arrhythmia.展开更多
文摘Stage Ⅳ breast cancer refers to breast cancer that has already metastasized to distant regions when initially diagnosed. Treatment for stage Ⅳ is intended to "prolong survival and palliate symptoms". Resection of a primary tumor is considered to be "effective only at alleviating chest symptoms and providing local control" in spite of the advances of imaging examination and medication for breast cancer. Molecular target and endocrine drugs are very effective and useful to tailor-make a treatment strategy according to breast cancer subtypes. Positron emission tomography-computed tomography can detect and diagnose the very small metastases and recurrences which can potentially be cured even if they are distant metastases. Recently, many retrospective studies have reported the survival benefit of surgery for breast cancer patients with metastases and some clinical trials which confirm the surgical prognostic benefit for them have started to enrol patients. The goal of treatment has to be clearly identified:increase the patient's survival time, provide local control or perform histology to determine the cancer's properties. The best evidence is absolutely essential to treat patients who need surgery at the right time. We need to evaluate the treatment strategy, including primary resection for stage Ⅳ breastcancer particularly, and find new evidence by prospective analysis.
文摘Hereby we describe a case of LAF developed after a surgical Maze procedure that demonstrates the importance of a systematic approach to mapping and ablating atypical atrial flutter to prevent a recurrence of symptomatic arrhythmia. In patients with previous cardiac surgery procedures, and in particular after a surgical maze, there are many different potential LA reentry circuits that involve various pathways. Both activation mapping and entrainment mapping were performed in order to identify the critical isthmus of the circuit and to effectively terminate the arrhythmia.