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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The potential association of breast cancer and caffeine intake was examined using international aggregate data. Death rates from breast cancer were correlated with caffeine ingestion from tea and coffee sources in 44 countries. By using multiple regression analysis, the authors demonstrated that 85% of the international variation in breast cancer rates is associated with variations in fat intake. When this is accounted for, the partial correlation of breast cancer rates with caffeine intake is negative (and significant at P less than 0.05). When the data are weighted by populations in each country, the negative partial correlation of caffeine with breast cancer disappears, but the strong positive association with fat intake remains unchanged. Although there have been suggestions that caffeine exacerbates fibrocystic disease of the breast and may be a causal factor in breast cancer, data from this study do not support a positive association between caffeine intake and subsequent development of breast cancer.
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PMID:Caffeine ingestion and breast cancer. A negative correlation. 327 91

Benign breast disease affects almost all women, although only one out of 11 will eventually develop breast cancer. Fibrocystic disease or benign breast mastopathies have been associated with an increased propensity to progress to malignancy. However, the increased relative risk for women with benign breast disease developing breast cancer appears to be associated with proliferative benign disease in association with atypia. Their cumulative risk may be as high as 30%. These women represent 3-5% of women with benign disease. They clearly warrant more careful screening and follow-up. The etiology of benign breast mastopathies is unknown, but its incidence and relationship to hormonal events suggests that many of the histologic entities represent an endocrine response. Many hormonal manipulations have been shown to decrease mastodynia and reduce the incidence of breast aspirations and biopsies. However, these and other therapeutic interventions have not been shown to reduce the incidence of breast cancer in women who are at high risk.
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PMID:Breast diseases and the internist. 329 52

With rapid improvements in plastic surgery techniques over the past 15 years, breast reconstruction after mastectomy has become a reasonable option for most breast cancer patients. In most patients who have had a modified radical mastectomy, the breast can be easily reconstructed with a subpectoral Silastic implant. In those who have had more extensive resections of tissue or radiation damage of the skin, reconstruction can still be reliably carried out by using either a latissimus dorsi flap in addition to the implant or by using the transverse rectus abdominis myocutaneous flap reconstruction. In many patients who reject these more complicated options, breast reconstruction can still be carried out with tissue expanders and subsequent placement of a subpectoral Silastic implant. For patients who desire prophylactic removal of breast cancer with extensive fibrocystic disease or precancerous histologic changes, subcutaneous mastectomy with immediate reconstruction offers maximum removal of breast tissue with minimal distortion of body image.
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PMID:Plastic surgical procedures related to breast disease. 343 73

The activities of hexokinase, phosphofructokinase, aldolase, enolase and pyruvate kinase were studied in breast cancer tissues, in comparison to benign breast disease and normal breast tissues. The enzyme activities in breast cancer were significantly increased compared to normal and benign breast tissues (p less than 0.001). Also the increase in activity in benign disease compared to normal was statistically significant (p less than 0.001). Within the group of benign diseases, fibroadenomas could be distinguished from fibrocystic disease, the former generally showing higher activities compared to the latter (p less than or equal to 0.05). Carcinoma subgroups, classified according to their histology, could not be recognized enzymologically. In addition, isozyme composition of pyruvate kinase and enolase was studied. We did not find a significant shift towards K type pyruvate kinase expression in benign disease compared to normal breast tissues. Also fibroadenomas did not differ from fibrocystic disease. However, the amount of K type pyruvate kinase in carcinomas proved to be significantly higher in comparison to benign disease and normal breast tissues (p less than 0.001). Expression of alpha gamma-enolase in normal breast tissue was virtually absent. In benign disease only a minority of specimens did show the hybrid alpha gamma-enolase. Nearly all carcinomas had alpha gamma-enolase expression and in 20% of the carcinomas gamma gamma-enolase could be detected (so-called neuron-specific enolase). By discriminant analysis, the function giving the best discrimination compared to the histological data was based on natural logarithm aldolase and the total of gamma-enolase subunits. Contrary to expectation, the regulator enzymes of glycolysis; i.e., hexokinase, phosphofructokinase and pyruvate kinase were not included in this discriminant function. The best fit produced a 90% correct classification in both benign and malignant disease. If these findings are confirmed to a larger series, the discrimination is sufficiently strong to form the basis of a clinically useful tool.
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PMID:Glycolytic enzymes in breast cancer, benign breast disease and normal breast tissue. 344 71

Some hormones (e.g., gonadotropins and clomiphene) act indirectly on the breast by disturbing the hypothalamopituitary axis, while others, including estrogens and progestins, exert at direct effect. Numerous experimental studies have confirmed that estradiol and progesterone act synergistically in the breast, and there are often differential responses of the alveolar and ductal systems. Analysis of fibroadenomas with high epithelial cell density removed from young women at various stages of the menstrual cycle indicated that receptors in both breast and endometrial tissues are under the control of cyclic ovarian function. When breast tumor tissue were exposed to estradiol and progesterone in well-balanced combination, a cell distribution of progesterone receptors similar to that observed during a normal luteal phase was observed. On the other hand, when estradiol is administered in supraphysiological doses to female rats, changes comparable to human fibrocystic disease are noted. The anti-estrogenic mechanisms of action of progesterone and progestins in women includes a reduction of estrogen secretion in systemic circulation, inactivation of estradiol by metabolism at the target tissue, and a lowering of estrogen receptors in these tissues. The main enzyme involved in the anti-estrogenic activity is the progesterone-dependent 17 beta-hydroxysteroid dehydrogenase. In terms of benign breast disease, a context of unopposed estrogen is most likely. Since benign breast disease can be a precursor of breast cancer, caution should be exerted in prescribing mini-pills to young women. Estradiol levels in mini-pill users can remain between 50-120 pg/ml given the persistence of some gonadotrophic activity and the consequent partial follicular maturation of the ovary.
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PMID:Effects on the breast of drugs used in fertility regulation. 347 70

In a prospective longitudinal study over several years, 58 patients with breast cancer are compared to 52 patients with fibrocystic disease and 24 patients with mastodynia. Results of coping (as assessed with the Bernese Coping Modes) are presented for the illness course of the first 6 months: (1) There is considerable variation of coping depending on illness situation and illness state. A core group of coping modes is predominant in most situations: 'attention & care', 'problem analysis', and 'Tackling'. In average 10 different coping modes were used by patients per given illness situation. (2) The different aspects of illness (in the same organ) ask for different coping. In the initial evaluation phase, however, the possibly fatal diagnosis overrides these differences. (3) Change over time (first 6 months) is net. Besides the core group of coping modes mentioned above, there is more variability in coping; in cancer a trend from a more fighting to a more accepting attitude is obvious; in fibrocystic disease more restricted coping is observed. Interdependence of coping with emotional stability and social adaptation will be studied as well.
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PMID:Coping with breast cancer--a longitudinal prospective study. 350 16

The pathophysiology of fibrocystic breast disease is determined by estrogen predominance and progesterone deficiency that result in hyperproliferation of connective tissue (fibrosis), which is followed by facultative epithelial proliferation; the risk of breast cancer is increased twofold to fourfold in these patients. The clinical correlate of fibrocystic disease is reflected by breast and axillary pain or tenderness in response to development of fibrocystic plaques, nodularity, macrocysts, and fibrocystic lumps. The disease progresses with advancing premenopausal age and is most pronounced in women during their 40s. Fibrocystic changes regress during the postmenopausal period. Medical treatment of fibrocystic disease is accomplished: by suppression of ovarian estrogen secretion with a low-estrogen oral contraceptive, whereby the action of estrogen on breast tissues is opposed by the oral contraceptive's progestin component (19-nortestosterone derivatives), or by cyclic administration of a progestogen (progesterone, medroxyprogesterone acetate) that modulates the mammary effects of estrogen. These treatment modalities are equally as effective as or superior to danazol therapy, which entails side effects in the majority of patients. Adjuvant therapy of fibrocystic breast disease with vitamin E is of value in patients with borderline or abnormal lipid profiles (low plasma levels of high-density lipoprotein and high plasma levels of low-density lipoprotein). With thorough diagnostic evaluation, appropriate medication, and close follow-up, treatment success can be achieved in almost every patient. Needle aspiration biopsy should be performed in patients with macrocysts and whenever clinical, ultrasonic, and/or mammographic examinations are suspicious for carcinoma. Patients at high risk of breast cancer (breast cancer in mother and/or sister) should have clinical examinations at 4- to 6-month intervals and mammography every 1 to 2 years; needle aspiration should be performed when the slightest suspicion arises. Fibrocystic breast disease is not a "harmless nondisease" but a distinct clinical entity that requires treatment to bring about relief to the patient, to reduce the incidence of breast surgical procedures, and to diminish the risk of breast cancer.
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PMID:Fibrocystic breast disease: pathophysiology, pathomorphology, clinical picture, and management. 351 5

In 1985 the University of Michigan Medical Center established a multidisciplinary breast care center (BCC) to provide comprehensive diagnosis and treatment for patients with benign and malignant breast disease. Ninety-eight per cent of the first 500 new patients were women and 2 per cent were men. One-hundred thirty-one women (26.7%) and no men had breast cancer. Of the remaining 359 women, 75.3 per cent had some element of fibrocystic disease. Patients who had breast cancer were evaluated during their initial visit to the BCC by a nurse, general surgeon, radiation therapist, and oncologist. Ninety-five per cent of all patients were given a definitive treatment plan or a second opinion at the conclusion of their one visit to the center. Patient and physician satisfaction with the center concept has been high. The center emphasizes patient education and choice between mastectomy and breast-sparing procedures and radiation therapy for the control of primary cancers. Adjuvant chemotherapy or hormonal therapy is given to all nodal-positive patients. Establishment of multidisciplinary centers, such as the BCC, requires the commitment of all physician specialty groups, nursing and hospital administration. High quality patient care can be provided in such centers in a more efficient and coordinated manner than in the non-center setting. The center can serve as a source of increased patient referrals and research opportunities.
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PMID:Developing a comprehensive breast center. 360 61

A forensic autopsy series of 519 women more than 14 years old was studied for prevalence of benign, atypical, and occult malignant breast lesions. The women included Anglos (non-Hispanic whites), Hispanics, and American Indians from New Mexico and Eastern Arizona. These three ethnic/racial groups are at markedly different risk for the development of breast cancer (Anglo 89 of 100,000 women per year, Hispanic 45.5, and American Indian 24.9. There were striking ethnic/racial and age-related differences in both the prevalence and magnitude of all forms of nonproliferative and proliferative fibrocystic disease. The various subsets of fibrocystic disease were highly associated with each other. Such lesions as apocrine metaplasia, sclerosing adenosis, and lobular microcalcification showed as much difference according to ethnic/racial background and age as the more common cystic change and duct epithelial hyperplasia. Atypical lobular and ductal hyperplasia, carcinoma in situ, and occult invasive carcinoma were uncommon and also occurred in ethnic/racial groups in a pattern that parallels the cancer risk in those groups.
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PMID:Prevalence of benign, atypical, and malignant breast lesions in populations at different risk for breast cancer. A forensic autopsy study. 367 9

To assess the usefulness of carcinoembryonic antigen (CEA) estimation in nipple discharge for the detection of nonpalpable breast cancer, CEA activity in nipple discharge was measured by enzyme immunoassay using monoclonal antibody. The specificity of the antibody for breast cancer was assessed by an immunohistochemical method. Mean CEA levels in the nipple discharge from 18 patients with benign breast diseases (ten intraductal papilloma; eight fibrocystic disease) was 43 ng/ml (SD, 34 ng/ml), suggesting an upper reference limit of 100 ng/ml. Six of seven nonpalpable breast cancer patients had higher CEA levels than this tentative cutoff value, as did three of five patients with borderline lesions. The incidence of elevated CEA levels in nipple discharge correlated significantly with the incidence of intratumoral antigen expression. These results lead us to conclude that CEA measurement in nipple discharge may be a useful adjunct in the diagnosis of nonpalpable breast cancer.
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PMID:Carcinoembryonic antigen estimation in nipple discharge as an adjunctive tool in the diagnosis of early breast cancer. 367 24


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