Case Files Surgery
BREAST MASS:
- radiation therapy is indicated for pt with stage I dz tx with breast conservation therapy
- this reduces the rate of recurrence from 30% to 9%
- post-menopausal or non-lactating women with red/tender breasts should be assumed to have breast cancer until proven otherwise
- tamoxifen therapy assoc with uterine cancer
- systemic therapy is given when widespread mets is dx or when pt is high risk for distant mets
GERD:
- if hoarseness and wheezing, suggests pharyngeal reflux with silent aspiration
- if dysphagia and/or weight loss think malignancy
- do endoscopy to evaluate for esophagitis, 24-hour pH monitoring can quantify severity
- H2 blockers may provide sx'atic relief, PPIs are superior for decr acid production
- ~50% of pts with GERD develop complications such as peptic strictures, Barrett's esophagus, and extraesophageal complications
- when LES is abnormally located, as in hiatal hernia, anti-reflux mechanism may be compromised at the GE......
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