Not Available
Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
In their report regarding the use of cryosurgery for breast cancer, Staren et al1 bring to bear the latest technology permitting the precise placement of cryoprobes and monitoring of the cryolesion. However, it is important to communicate that cryosurgery of breast cancer, for small and localized as well as advanced and unresectable disease, has been used for almost 30 years.
As early as 1968 and through 1994, Tanaka2 has treated 9 primary advanced and 40 recurrent breast cancers with cryosurgery. All cases were considered incurable: advanced, unresectable, and resistant to radiotherapy, chemotherapy, and endocrine therapy. The 3- and 5-year survival rate for these primary advanced breast cancers treated cryosurgically was 44%.2
In 1976, LePivert3 reported the cryosurgical treatment of 7 cases of locally advanced breast cancer (5 stage III, 2 stage IV) using single and multiple cryoprobes. There were varying degrees of responsiveness, including 2 patients with local recurrences and 1 patient with regression of regional lymph node involvement, and 2 patients were disease-free at 1 year.3
Recently, Suzuki4 summarized results from the treatment of 8 patients (including 1 treated with cryolumpectomy) with primary stage IV breast cancer from 1982 to 1989. Survival times ranged from 6 months to 5 years and included regression of contralateral breast tumor and lymph node metastases, reduction in size of the tumor at metastatic sites, or both. Disease-free intervals ranged from 6 months to 4 years. Tumor marker and immunological studies, including an increase in activity of tumor necrosis factor after cryosurgery,4 while suggestive of an immune response, were unfortunately incomplete or inconclusive.
Although it has yet to be fully defined in cryosurgery of breast cancer, one of the principal advantages of cryosurgery over conventional treatments is that the cryogenic destruction of tumor and the potential to elicit an antitumor immune response to augment localized and secondary destruction of tumor cells provides a "double-edged sword" to the therapeutic armamentarium for cancer.5 The immunologically related remissions of metastases after cryosurgery referred to by Staren et al were mentioned, but were not observed by the authors of the references cited by Staren et al. These remissions were initially reported by myself and other researchers in cryoimmunology.5
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Archives of Surgery editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.