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

The epidemiology of breast fluid secretion was studied on the basis of nipple aspirates of breast fluid obtained from 3,929 nonlactating women of various racial groups. The results confirmed and extended earlier findings by our group: Variation in the proportion of secretors was related to most breast cancer risk factors, including age, race, age at menarche, age at first pregnancy, age at menopause, clinically diagnosed fibrocystic disease, menopausal estrogen use, and cerumen phenotype. Secretory activity as measured by nipple aspiration appeared to reflect hormonal and genetic effects on breast epithelium.
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PMID:Epidemiology of breast fluid secretion: association with breast cancer risk factors and cerumen type. 694 66

Natural cytotoxicity was studied before surgery or other treatment in 83 women with primary, untreated breast cancer. Peripheral blood lymphocytes (PBL) and cytotoxicity of regional lymph node cell(s) (RLNC) were examined in a 4-hour 51Cr release assay against the target cell K-562. Results indicated that greater than one-third of breast cancer patients have more negative lymphocyte cytotoxic activity toward K-562 than do the other two-thirds. Similar results were observed for PBL of 25 patients found to have benign breast lesions. Of these patients, 23 had fibrocystic disease. The difference between these findings and findings with normal control lymphocytes studied in parallel was highly significant (P less than 0.001). The study of RLNC cytotoxicity in patients with breast cancer showed that 25% of the patients' RLNC had significant natural cytotoxic activity toward K-562. Incubation of RLNC with interferon in vitro before addition of labeled K-562 cells did not induce cytotoxicity in RLNC that did not have this activity initially.
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PMID:Natural cytotoxicity of peripheral blood lymphocytes and regional lymph node cells in breast cancer in women. 694 30

There are an estimated 8-10 million oral contraceptive (OC) users in the U.S. Investigation of the effects of OCs on neoplasia is not easy; currently 4 investigative methods are used: 1) case reports, 2) disease rate and trends, 3) case-control studies, which are the main source of careful retrospective information, and 4) cohort studies, which compare the incidence of disease in patients exposed to suspected environmental factors, and in those who are not exposed. Major risk factors for carcinoma of the breast are female sex, age, genetic predisposition, previous benign breast disease, and previous cancer of one breast; undetected breast cancer may be present for many years before diagnosis, and risk is increased in patients with chronic cystic mastitis or fibrocystic disease of the breast. Clinical observations have suggested a strong association between endocrine influence and the incidence or progression of breast cancer; current evidence tends to support the role of estrogens in the etiology of carcinoma of the breast with respect to long-term estrogen administration, but this evidence is not valid for young patients who are on combined OCs. Most studies have documented a decreased risk of benign breast disease with length of OC use persisting for 4 years; these studies, however, did not analyze lesions by histologic type. Studies that show a protective effect on benign disease do not show the same protective effect for breast cancer. Data from cohort studies show no association of OCs with breast cancer. Since 1972 a number of reports have associated OCs with liver tumors, stating that risk increases with duration of use. A national survey revealed that the frequency of malignant tumors increased with age, but that the frequency of benign lesions had a peak in the 26-30 age group which corresponds to increased use of OCs. Benign tumors are dangerous because they tend to rupture spontaneously. The association between pituitary adenoma, causing postpill amenorrhea, and OC use is very controversial. OC use may also cause endometrial hyperplasia; postmenopausal estrogen use has also been associated with endometrial carcinoma, although the causal relationship has never been proven; progestogens may be useful in the therapy of some endometrial carcinomas. Carcinoma of the cervix seems to be more influenced by age at 1st intercourse and by multiple sexual partners than by OC use; several case-control studies have shown that there is no significant difference between incidence among OC users and nonusers. Data about the association between OCs and ovarian carcinoma are reassuring but incomplete. OCs should not be used in patients with positive chorionic gonadotropin titers who have been treated for hydatidiform mole.
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PMID:Neoplasia and hormonal contraception. 702 11

Fibrocystic disease of the breast (FCD) is an exaggeration of the normal physiologic response to cyclic estrogen and progesterone stimulation. The disorder can persist, with much less severity, in the menopausal woman. Whether FCD predisposes to mammary cancer remains moot. A new steroidal agent, danazol, can eliminate nodosities in the majority of women with FCD. Thermography may identify women who are at greater risk because of increased heat production. Mammography should be employed in women with persistently abnormal thermograms, even though no suggestive breast masses are palpable. Needle biopsy or surgical biopsy should be undertaken whenever a firm indurated mass is palpated, regardless of negative findings with a thermogram or mammogram. In a series of 1548 women treated for 10,715 women-years, the incidence of breast cancer after prolonged estrogen therapy was not increased. Although estrogens and prolactin have been incriminated in the etiology of mammary cancer, no hard facts exist to confirm such allegations.
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PMID:The role of estrogens in mastopathy and mammary cancer in perimenopausal women. 706 88

The five-year screening experience for 10,131 asymptomatic women evaluated at the Louisville Breast Cancer Detection Demonstration Project (LBCDDP) disclosed 144 breast carcinomas in 1,209 patients (12%) aged 35 to 74 years in whom 904 biopsies and 305 aspirations were performed. This study included 44,711 high-quality xeromammograms (XM) prospectively classified by the modified Wolfe mammographic parenchymal patterns into low-risk (N(1), P(1)) versus high-risk (P(2), DY) groups, with expansion of the P(2) cohort into three additional categories. Using BMDP computer-program analysis, each XM pattern was collated with 21 nonneoplastic and 18 malignant pathologic variables and commonly associated risk factors. A separate analysis of epithelial proliferative and nonproliferative fibrocystic disease of the breast (FCDB) was performed. The histopathology for each biopsy, with distinction of FCDB and neoplasms, was analyzed with regard to the statistical probability of influencing the XM pattern. An average of 1.05 biopsies per patient were performed in women with findings suggestive of carcinoma at clinical and/or XM examinations. An equal distribution of the N(1), P(1), and P(2) DYXM patterns was observed in the 10,131 screenees. Of 8.5% of the screened population having biopsies, 623 were observed to have nonproliferative FCDB and 137, proliferative FCDB. For women 50 years of age or younger, these pathologic variables were seen more frequently in the P(2) DY patterns (p < 0.001), whereas no difference in XM pattern distribution was observed for the screenee 50 years of age or older for proliferative FCDB (p = 0.65). Sixteen percent of the biopsied/aspirated lesions were carcinomas, yielding a biopsy/cancer ratio of 6.25:1. These in situ and invasive neoplasms were more commonly (p < 0.04) observed in 55% of the P(2) (P(2f), P(2n), P(2c)) categories, while 64% of all cancers appeared more frequently in the P(2) DY subgroup (p <0.001), compared with this pattern in the screened population. An equal distribution frequency of the XM classification existed for screenees 50 years of age or older with cancer (p = 0.50), while screenees 35-49 years of age were more often observed to have the high-risk P(2), DY patterns (p <0.001). Analysis of 1,759 histologic characteristics in biopsies of 863 patients with FCDB revealed ductal and lobular hyperplastic lesions, sclerosing adenosis, or epithelial cyst(s) to be the major constituents of 64-69% of the high-risk P(2) (P(2f), P(2n), P(2c)) image (p < 0.001). These data suggest that XM parenchymal patterns observed in asymptomatic screenees incompletely correlate with known pathologic variables and risk factors. Additionally, benefit for recognition of these preinvasive proliferative pathologic factors and carcinomas appears restricted to the younger screenee. The clinical integration of these risk factors with XM patterns may allow preselection of patients deserving of frequent follow-up for breast cancer; however, these data do not support the contention that Wolfe XM patterns are predictors for screening strategies or that they decisively enhance patient management.
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PMID:A clinicopathologic correlation of mammographic parenchymal patterns and associated risk factors for human mammary carcinoma. 707 55

Even though mammographic techniques have improved and small tumors of 0.5 cm in diameter can be detected, decreased breast cancer mortality has not yet resulted. Because small tumors may cause systemic spread, in many patients breast cancer at the time of diagnosis is a systemic disease which is incurable. A reduction in breast cancer mortality seems possible by prophylactic bilateral mastectomy in women at extraordinary high risk of breast cancer. These are patients with (a) breast cancer in mother and sister, (b) breast cancer in mother or sister and a combination of various risk factors (early menarche - late menopause, nulliparity, late first pregnancy), (c) noninvasive malignant breast disease (carcinoma in situ), (d) therapy-resistant fibrocystic disease with intolerable pain and/or extreme anxiety (carcinophobia, and (e) benign breast neoplasia with malignant potentials (cellular atypia = precancerosis). Also, in breast cancer patients without regional and systemic spread and who are at high risk for developing cancer in the other breast, prophylactic contralateral mastectomy may be indicated. These are patients with (a) unilateral invasive breast cancer in the premenopause and a family history (mother or sister) of breast cancer, (b) unilateral invasive lobular carcinoma or tubular (ductal) carcinoma, and (c) unilateral invasive breast cancer and precancerous lesions in the other breast.
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PMID:Aspects of breast cancer control: is prophylactic mastectomy a feasible modality? 708 17

Benign breast disease (BBD), of which fibrocystic disease (FCD) is the most common, results from an imbalance in estrogen-progestogen ratios or inappropriate target gland response to changing tides of hormonal stimulation. Histologically, FCD may present as simple cystic glandular hyperplasia, adenosis, chronic cystic mastitis with apocrine metaplasia, and ductal papillomatosis. Fibroadenoma, a pseudoencapsulated tumor, is another variant. Experimental animal data yield some clues as to the etiology of FCD, but extrapolation to the human may be inappropriate. The anovulatory female rarely develops severe FCD, as manifested by marked pain and lumpiness. Oral contraceptives (OCs) reduce the incidence of FCD and the frequency of mammary cancer in comparison with controls. The administration of methyltestosterone, and at times testosterone, to males has resulted in multiple soreness and gynecomastia. Cancer of the breast has occurred in 2 male transvestites who had been on estrogens. The development of mammary cancer in men on stilbestrol therapy for prostatic cancer has recently been challenged. 1 in 11 women in the U.S. will develop breast cancer in her lifetime. Warren has claimed that malignancy was 4.5 times greater in women who had been biopsied for FCD than in normal female population. Cole and MacMahon reviewed the world literature and found the presence of FCD increased the risk of cancer by 2.64 times. FCD is an exaggeration of the normal tissue response of the breast resulting from the ebb and flow of ovarian hormones. FCD is characterized by pain and tenderness, most marked in the premenstrual period but later may continue throughout the cycle. The lumpiness or nodularity may be localized or generalized, unilateral or bilateral. Reported surveys showing that oral contraceptives (OCs) lessen the incidence of FCD suggest that hormonal manipulation can effectively reduce the frequency of this disease, and, possibly in turn, the incidence of mammary cancer. Cystic masses should be aspirated and the contents examined for cytologic atypia. It is important to find those women who are at greater risk of developing mammary cancer because of florid fibrocystic disease. FCD should be medically managed unless a dominant lump develops, in which case a biopsy should be performed. The use of a newsteroidal agent, danazol, on a 3-6 month trial of 100-400 mg/day will eliminate pain and nodosities in some 69% of women and in another 30% the signs and symptoms will be diminished.
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PMID:Fibrocystic disease of the breast. 710 13

The pubertal breast may be the seat of lesions comparable to those of the adult female breast. Of the five girls referred to in this report, aged 11 to 15 years, three had fibrocystic disease, one had a huge intracystic papilloma and the last one had multiple papillomas. The two girls with fibrocystic disease and the one girl with multiple papillomas had a family history of breast cancer which had appeared in their grandmothers. The possible relationship between the breast diseases of the two generations is discussed.
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PMID:Breast masses in young girls. Report of five cases. 713 66

Changes in the breast begin at the time of puberty because of the cyclical influence of ovarian hormones. This intermittent stimulation usually results in some nodularity of the breast by the time a woman reaches 30 and frequently at an earlier age. The real importance of fibrocystic disease is related to the problem of differential diagnosis of benign from malignant lumps. Mammography has become the standard method for detecting lumps in the early, nonpalpable stage, but refinements in thermography, ultrasound, and CT scanning may become more useful. Considerable work is apparently being done on various chemical markets, but at the present time, they are not sufficiently reliable for routine clinical use. Fine needle aspiration biopsy with cytologic analysis has become more popular as a detection method, and core needle biopsies with histology are sometimes used. Analysis of nipple secretions for chemical markers or for cytologic diagnosis may become more reliable. A combination of factors will probably give the best results, at least in the foreseeable future, and the judgment of an informed and skilled examiner will remain the best method for the detection of early breast cancer for many years to come.
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PMID:The early diagnosis of breast cancer. 727 77

The identification of genetically susceptible individuals may permit the determination of genetic and environmental interactions which result in disease. This paper presents some recent findings on possible genetic-environmental interactions in breast disease as determined by a "nature-nurture" model employing epidemiological risk factors and cytologic studies of breast secretions obtained by nipple aspiration. The findings indicate that severe changes in the cytologic characteristics of the fluid are associated with a positive family history of breast cancer and clinical fibrocystic disease. These findings were interpreted as supporting the hypothesis that women with such a family history may have increased susceptibility to environmental factors. This model may have utility in other environmental epidemiologic studies.
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PMID:Genetic-environmental interactions in relation to low dose studies: a possible model from breast cancer. 733 66


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