The case histories of 263 patients with histologically proven endometriotic cysts of the ovaries (1962–1979) were studied. The diagnosis frequency increased continuously during the observation period. Most patients were aged 35–39 years. The admission diagnosis was rarely endometriosis. The clinical picture and the extent of the disease rarely showed correlation.

Purpose: Surgical techniques, especially with a higher risk, must always critically considered. It is the objective of this paper to show that for complete removal of advanced pelvic endometriosis even partial bowel resection may be indicated to retain ovarian function. Material and Method: From February 1, 1985 through December 31, 1995 laparotomy was performed in 223 women at the Kreiskrankenhaus Neumarkt i.d.Opf. for advanced pelvic endometriosis. In 47 patients a complete section of the big bowel mostly including the sacrouterine ligaments had to be removed to resect all areas of endometriosis. In 12 of these patients the uterus together with a fallopian tube and some functional ovarian tissue was retained. All patients were clinically checked approximately eight weeks after surgery and were interviewed by telephone one to nine years later. Results: The analysis of pain as the cardinal symptom - we differetiated between lower abdominal pain in gener- al and dyspareunia and painful miction or defecation - resulted in an improvement in 2/3 to 3/4 of either group. Menstrual pain was lowered in 80% of the patients who underwent uterus-conserving surgery. The interval of menstrual bleeding was shortened in about 35% and extended in roughly 60%. Five pregnancies were achieved in eight patients who desired children. Two of these pregnancies resulted in early miscarriage, three in term delivery. Surgery was complicated by a rectovaginal fistula in one case. This fistula disappeared under conservative treatment. Conclusion: Inspite of new methods in the treatment of endometriosis radical surgery including the removal of bowel in advanced cases remains an important therapeutic option: Avoiding the disadvantages of hormonal withdrawal, satisfactory long-term results are achieved. In some cases women i desiring children may benefit from this therapy.

Purpose: Surgical techniques, especially with a higher risk, must always critically considered. It is the objective of this paper to show that for complete removal of advanced pelvic endometriosis even partial bowel resection may be indicated to retain ovarian function. Material and Method: From February 1, 1985 through December 31, 1995 laparotomy was performed in 223 women at the Kreiskrankenhaus Neumarkt i.d.Opf. for advanced pelvic endometriosis. In 47 patients a complete section of the big bower mostly including the sacrouterine ligaments had to be removed to resect all areas of endometriosis. In 12 of these patients the uterus together with a fallopian tube and some functional ovarian tissue was retained. All patients were clinically checked approximately eight weeks after surgery and were interviewed by telephone one to nine years later. Results: The analysis of pain as the cardinal symptom - we differentiated between Tower abdominal pain in general and dyspareunia and painful miction or defecation - resulted in an improvement in 2/3, to 3/4 of either group. Menstrual pain was lowered in 80% of the patients who underwent uterus-conserving surgery. The interval of menstrual bleeding was shortened in about 35% and extended in roughly 60%. Five pregnancies were achieved in eight patients who desired children. Two of these pregnancies resulted in early miscarriage, three in term delivery. Surgery was complicated by a rectovaginal fistula in one case. This fistula disappeared under conservative treatment. Conclusion: Inspite of new methods in the treatment of endometriosis radical surgery including the removal of bowel in advanced cases remains an important therapeutic option: Avoiding the disadvantages of hormonal withdrawal, satisfactory long-term results are achieved. In some cases women desiring children may benefit from this therapy.

For several years it is known that there is no difference in the rate of survival and distant recurrence for patients treated by segmental resection or by mastectomy.However, it is unsatisfactory that there is an increased occurence (30 %) of local recurrence at patients without breast irradiation compared with additional irradiated patients (10 %).During more than 10 years, 100 patients with conservative surgery at the Unlversitets-Frauenklinik Erlangen were followed up.

67 breast cancers with a maximum diameter of up to 10 mm on the histological section were retrospectively analysed according to the primary situation for medical consultation and the way to cancer diagnosis. 46 women presented themselves with clinical signs. 19 women had an anamnestical risk, whereas only two women were without any risks or symptoms. 34 tumourspecific clinical signs are followed by 25 tumourspecific mammograms. Eight small invasive carcinomas were detected only under the microscope, two of them in mastectomy specimens. Even small cancers, therefore, are mostly diagnosed from the patients themselves. The contribution of mammography is tremendous. Intensified systematic histological examination of biopsies and mastectomy specimens is mandatory especially in high risk patients.

Die Diskussion und das Vorlegen von Erfahrungsberichten im Arbeitskreis hat ergeben, daß eine Früherkennung des Endometriumcarcinoms mit geeigneten morphologischen Methoden grundsätzlich möglich ist.

In the last 19 years 47,518 women had mammographies at the Department of Gynaecology of the University of Erlangen. 1653 patients had 2215 galactograms. Biopsies of the breast indicated by mammography were done in 1521 cases. 955 cases showed micro-calcifications in groups. 566 showed abnormal galactograms. The microscopic examination in the 955 cases with microcalcifications showed invasive carcinoma, carcinoma in situ or atypical epithelial proliferations in 1/3 of the cases In 10% of the cases small calcified fibroadenomata, papillomas or granulomas were found. In 60% of the biopsies mammary dysplasia partly with nonatypical epithelial proliferations were found. When the galactogram showed pathological contours the breast tissue was excised in a segment. In over 40% of 566 segmental excisions papillomata were the cause of pathological secretions from the breast. Ductal carcinomas, carcinoma in situ and extensive intraductal solid papillary or adenomatous epithelial proliferations were found in 27% of the cases. Approximately the same number of cases did not show atypical epithelial proliferations. Delay in the early diagnosis of changes which may be the first sign of malignant breast disease can be avoided by good cooperations between the physicians treating the cases.

Receptor assay results were compared with the ultrastructure of 127 breast cancers (112 primary tumors, six recurrent lesions, nine metastases). Tumors were considered to be receptor positive if the receptor levels were ⩾ 15 fmol/mg of soluble tissue protein. Most breast cancer had heterogenous cells with different grades of ultrastructural differentiation. A prevalence of well-differentiated cancer cells and an abundance of intracytoplasmic vacuoles had a significant correlation with a positive estrogen receptor status. The correlation was better than between malignancy grades and receptor content. The type of breast cancer and the menopausal status bore no relation to receptor content. Progesterone receptors were found in well-differentiated tumors of low malignancy.

Twenty-eight small breast cancers and 17 other breast cancer specimens from which appropriate semi-thin sections had been prepared were examined by electron microscopy and special staining techniques for alterations in the basement membranes and the basal lamina. In each case disruptions of the basement membranes were invariably observed at the point of initial invasion. Two types of invasion were noted: (1) bud-like protrusions of intraduct cancer with disruption of the basement membranes at the point of invasion; (2) extensive basement membrane defects with single cancer cell invasion. Our study confirms that invasive breast cancer originates in intraductal or lobular carcinoma in situ.

484 women were operated between July 1, 1975 and December 31, 1978 for carcinoma of the breast. At least 18 months of follow-up was available until July 1, 1980. 273 patients were observed. 151 women had ancillary chemotherapy with cyclophosphamide, methotrexate, vinblastinsulphate and fluoro-uracil for six cycles. In an additional 60 patients chemotherapy was interrupted for post-operative radiotherapy after three cycles. The premenopausal patients were most helped by ancillary chemotherapy. This was not explained by more frequent mistakes in the treatment of post-menopausal patients. The post-operative radiotherapy did not bring a discernible additional advantage to ancillary chemotherapy. The best results were obtained in women who had no regional metastases in the lymph nodes independent on the size of the primary tumour.

484 women were operated between July 1, 1975 and December 31, 1978 for carcinoma of the breast. At least 18 months of follow-up was available until July 1, 1980. 273 patients were observed. 151 women had ancillary chemotherapy with cyclophosphamide, methotrexate, vinblastinsulphate and fluoro-uracil for six cycles. In an additional 60 patients chemotherapy was interrupted for post-operative radiotherapy after three cycles. The premenopausal patients were most helped by ancillary chemotherapy. This was not explained by more frequent mistakes in the treatment of post-menopausal patients. The post-operative radiotherapy did not bring a discernible additional advantage to ancillary chemotherapy. The best results were obtained in women who had no regional metastases in the lymph nodes independent on the size of the primary tumour.

Die Korrelation des Steroidrezeptorstatus zu histomorphologischen Kriterien und der Prognose des operierten Mammakarzinoms*Am Krankheitsverlauf yon 220 in der Universitfits-Frauenklinik Erlangen operierten Brustkrebspatientinnen wurde geprfift, ob einerseits dem Steroidrezeptorgehalt ffir sich eine prognostische Bedeutung zukommt und ob andererseits Steroidrezeptorverhalten und histomorphologische Kriterien miteinander korrelieren

Portio-Abschabung und Cervix-Curettage (PA u. CC) wurden in einer prospektiven klinischen Studie simultan mit der individuellen Messer-Konisation verglichen. Die angestrebte Randomisierung mußte nach 2 Jahren aufgegeben werden zugunsten einerMatched-Pair-Analyse. 558 cytologische oder kolposkopische Verdachtsfälle wurden erfaßt. Für den engeren Vergleich standen 212 Portio-Abschabungen und Cervix-Curettagen 125 Messer-Konisationen und 64 primären Uterus-Exstirpationen gegenüber. 15 PA und CC mit negativen oder geringstgradigen Befunden wurden und werden zunachst überwacht.

Case report on a 80 year old patient with recurrent bleeding from a papillary adenofibroma of the uterus. The clinical and morphological findings of this case were compared with previous cases. A polypoid papillary adenofibroma of the endometrium is a benign mixed muellerian tumour.