The authors used radioactive colloidal gold (Au
198) in 8 cases of breast cancer for the purpose of preoperative radiation. The colloidal gold, injected into breast deposited in subcutaneous tissues and fatty tissues of breast, resulting black-purple staining, and reached at axillary lymphnodes, coloring them black-purple, thus facilitating the detection of lymphnodes at the time of radical operation.
With proper care, by the injection, colloidal gold distributed almost uniformly in breast. By injecting 50mc of colloidal gold, the radiation dose in the central part of breast reached at 7, 500-15, 200 rep of β-ray, and 1, 370-2, 250r of γ-ray, and the axillary lymphnodes received 130r of γ-ray, and about the half of them irradiated by β-ray in the dose of more than. 7, 600rep. The radioactive gold deposited also in the metastasied lymphnodes and gave 35, 000rep of β-ray, when they had not been filled up completely with cancer cells.
By histological examination, the colloidal gold in the breast was recognized as particles, mostly phagocytized by histiocytes. These particles accumulated in lymphatic vessels around blood vessels and mammary glands, intruding into connective tissue of the cancer. Inflammation was marked around the deposited gold particles, where epithelial elements showed irregularity of arrangement, atrophy and degeneration, and the blood vessels showed severe arteritis. The cancer cells were also heavily injured, showing atrophy, clunping and destruction of nucleus, and formation of vacuoles and giant cells. Particles of gold in lymphnodes were present in lymphsinuses and mostly phagocytized by sinus endothels and reticulum cells. Destruction of lymphatic tissues and lesions of blood vessels were noted. Metastatic cancer cells in nodes were also injured by radioactive gold in the same manner as in the prlmary focus. By microscopic examination, density of distribution of these partlcles in tissue was in parallel to the blackening of the film in autoradiogram, thus in case of gold (Au
198), distribution of radioactive substances in tissue could be demonstrated without using autoradiography.
Preoperative irradiation with Au
198 for breast cancer brought no significant colmplication and no marked change in blood picture, and gave considerably large radiation doses to breast and axillary glands, showing typical radiation effects, in histological pictures. We may expect the preventive effect by this method against recurrences and metastases of cancer in postoperative period.
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