Correspondence

Calcifectomy for ductal carcinoma in situ Sir The article by Wobbes et al . in the February issue of the Journal (Br J Surg 1989; 76: 185-6) discusses the problem of ductal carcinoma in situ. They state that microcalcifications may be the only sign of the lesion and that the biopsy procedure is aimed at removal of all microcalcifications. If a breast conserving operation is performed, the removal of the microcalcifications with free margins, and confirmation by specimen radiography to verify that microcalcifications have been removed, may be the only procedure necessary. The name of this procedure is microcalcificectomy ’ or calcificectomy (kal’si-fi-sek’tb-mi) or simply calcifectomy. It is an accurate description of this operation which no doubt will be increasingly performed in the conservative treatment of ductal carcinoma in situ.

M. R. Shetty

Northwest Community Hospital Arlington Heights Illinois 60005 U S A

1. Shetty MR (Ed). Microcalcificectomy for Early Breast Cancer. Northwest Community Hospital Medical Bulletin 1988; 24: 1.

Breast abscesses Sir In their recent correspondence (Br J Surg 1989; 76: 103), Mr Nash and Mr Powles indicate that many non-lactating breast abscesses associated with periductal mastitis are sterile on culture. This is incorrect. With appropriate culture techniques, bacteria can be isolated from most, if not all, non-lactating abscesses’. A combination of cephradine and metronidazole covers the majority of organisms isolated from these lesions.

I agree that breast abscesses can be treated by aspiration combined

with appropriate oral antibiotic treatment’. It IS important to note that in lactating breast abscesses, pus usually reaccumulates and multiple aspirations may be required.

J. M. Dixon The Royal Infirmary Edinburgh EH3 9YW U K

1.

2.

Bundred NJ, Dixon JM, Lumsden AB e t al. Are the lesions of duct ectisia sterile? Br J Surg 1985; 72: 844-5. Dixon JM. Repeated aspiration of breast abscesses in lactating women. Br Med J 1988; 297: 1517-8.

Paget‘s disease Sir We read with interest the recent paper by Armitage et al. (Br J Surg 1989; 76: 60-3). This was a review of eight patients with anal Paget’s disease since 1930. They concluded that the association with colorectal tumours may have been exaggerated in previous studies due to confusing Pagetoid spread from an underlying anorectal adeno- carcinoma with true Paget’s disease.

We agree with Armitage et al. as we have treated two cases of anal Paget’s over the last 3 years, neither of whom had associated malignancy. The first required an anterior resection for a tubulovillous adenoma which showed mild dysplasia, but there was no evidence of malignancy. Both have required local excision of the extramammary Paget’s which as yet have been curative.

D. Talbot T. W. J. Lennard

H. G . Brown R. M. R. Taylor

University of Newcastle-upon-Tyne Newcastle-upon-Tyne NE2 4HH U K

Erratum ‘Anastomotic suture materials and implantation metastasis: an experimental study’, by J. R. McGregor, D. J. Galloway, P. McCulloch and W. D. George, Br J Surg 1989; 76: 331-334, pages 332 and 333, Tables 1,2 and 3. The values for the stainless steel and polypropylene suture materials have been transposed. We apologize for this error. The Tables should read as follows:

Table 1 materials

The in vivo entrapment and transfer of Mtln3 cells by suture

Median number of cells Suture material transferred in uivo Range of values

Table 2 The in vitro adherence of Mtln3 cells to suture materials

Median number of cells Suture material adhered in uitro Range of values

3. Stainless steel 282 4. Polypropylene 155

172-861 56-662

Table 3 Radioactivity counts of sutures using free N a , 5 1 C r 0 , solution

Suture material i n uiuo study In vitro study

3. Stainless steel 545 4. Polvurouvlene 1197

141-3371 59-3434

Stainless steel 220 (142-407) 159 (1 14-337) Polypropylene 399 (144698) 144 (97-243)

Br. J. Surg., Vol. 76, No. 6, June 1989 655