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

The postoperative management of breast cancer is an ever-changing field. Young patients, in particular, have attracted recent interest as it has become apparent that age alone is a poor prognostic indicator for breast cancer. Adjuvant therapies indisputably delay breast cancer recurrence and save lives, and should be considered for all young patients. Chemotherapy is increasingly being considered appropriate for all women under the age of 35 years, regardless of other risk factors, but poses the particularly difficult problem of infertility for these young women. As the additional benefits of anthracyclines and taxanes in the adjuvant setting become clear, chemotherapy regimens are also becoming increasingly intensive and the risk of myocardial damage and leukaemia should not be ignored. The benefits of chemotherapy need to be weighed against the possible dangers, and therapy should be individualised according to cancer pathology and patient circumstance. Tamoxifen should be given for 5 years to all women whose cancer is estrogen receptor positive, regardless of whether the patient has received chemotherapy. If chemotherapy is not given, the addition of luteinising hormone-releasing hormone (LHRH) agonists to tamoxifen in patients with estrogen receptor positive breast cancers appears to be beneficial. The addition of LHRH agonists to chemotherapy and tamoxifen is currently being evaluated in randomised trials. Radiotherapy should be given after breast conservation surgery, and should include the axilla if nodes are involved and the axilla has not been surgically cleared. Chest wall radiotherapy should be considered following mastectomy in young women considered at high risk of local recurrence, but the long-term morbidity and mortality of local radiation therapy, which is increased in young women, needs to be considered.
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PMID:The value of adjuvant treatment in young women with breast cancer. 1179 Jan 54

A cohort of 786 women who received a diagnosis of polycystic ovary syndrome (PCOS) in the United Kingdom before 1979 was traced to investigate the long-term consequences of the syndrome. Data were obtained from death certificates for 70 women. Morbidity data were collected from general practice records and questionnaires for 319 women diagnosed with PCOS an average of 31 years previously and for 1060 age-matched control women. The proportion of women with involuntary infertility was 17.5% in the PCOS group compared with 1.3% in the control group. All-cause mortality in the cohort did not differ from that of the general population of women. Women with PCOS were not at significantly increased risk of mortality or morbidity from breast cancer but were at increased risk of endometrial cancer. Women with a history of PCOS had higher levels of several cardiovascular risk factors including diabetes, hypertension, raised plasma cholesterol and body mass index > 30 kg m(minus sign2). Mortality and morbidity from coronary heart disease did not differ significantly between the women with PCOS and comparison groups. Control of obesity is likely to be particularly important for women with a history of PCOS.
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PMID:Long-term consequences of polycystic ovary syndrome: results of a 31 year follow-up study. 1184 63

Recent discoveries on endocrine, paracrine and autocrine involvement of insulin-like growth factor-1 (IGF-1) in the proliferation of many tissues raised the attention of its role in reproduction and in the growth of various cancers as well as of benign proliferations. The intention of this article is to focus on IGF-1 in the field of gynaecology. Perimenopausal women who exhibit high IGF-1 and low IGF binding protein (IGFBP) levels, like IGFBG-3, have an increased risk of developing breast cancer. A higher risk for cervical, ovarian and endometrial cancer is related to high IGF-1 levels in post- and premenopausal women. It has been shown that myomas, by far the most common benign uterine tumor in women, grow in the presence of IGF-1, in vitro as well as in vivo. Studies show that IGF-1 is involved in the differentiation of various reproductive tissues, like endometrium and ovarian tissues. Patients suffering from polycystic ovary syndrome (PCO) frequently show insulin resistance accompanied by an increase of IGF-1 in plasma. Plasma IGF-1 levels are higher in cases of severe endometriosis, however, in endometriosis and in PCO IGF levels locally in the endometrium are reduced, what might explain infertility. Recently, it was shown that IGF facilitates the implantation of the human embryo in the endometrium during IVF. Implantation is a paradox where different immune systems have to collaborate to make implantation and survival of the pregnancy possible. IGF seems to be the starter molecule so that the two epithelia can fuse. A disturbance can result in complications during pregnancy i.e. spontaneous miscarriage, preeclampsia as well as defects of the embryo. Therefore, IGF is a useful marker in successful pregnancy as well. A better mechanistic understanding of IGF-1 action on the cellular level not only provides more elegant mechanistic explanations for the scientist, but the practitioner might find it interesting to utilize its diagnostic potential as a marker for various diseases. The relation between systemic IGF levels and local tissue IGF-1 levels has not yet been determined for all conditions.
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PMID:IGF-1 in gynaecology and obstetrics: update 2002. 1195 96

Obesity, the result of combined genetic and environmental factors, is in recent decades one of the most frequent diseases and is encountered mainly in Europe and North America. In women it is associated with the risk of several diseases, such as diabetes mellitus, osteoarthritis, cardiovascular diseases, sleep apnoea syndromee, breast cancer, cancer of the uterus and also with impairment of reproductive functions. Already during the last century some observations confirmed that a very low or very high body weight is more frequently associated with disorders of the menstrual cycle (MC), infertility and poor reproductive capacity. However only during the last decades the pathophysiological and molecular mechanisms of this relationship were gradually elucidated. The main factors which influences the menstrual cycle in obesity are: impaired estrogen metabolism, changes in the concentration of sex hormone binding globulin, hyperinsulinaemia, and probably also leptin levels.
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PMID:[Obesity and disorders of the menstrual cycle]. 1206 Nov 86

This article summarizes progress in the biochemical assessment of endocrine function through salivary steroid analysis. Improvements in immunoassay techniques have allowed the development of assays for salivary steroids that are appropriate for routine use in shortterm dynamic investigations, pharmacokinetic analyses, and studies of chronobiological changes. All steroids of diagnostic significance in the assessment of endocrine activity can now be measured in saliva. Assays for salivary progesterone and estradiol play an important role in investigations of female infertility, providing reliable information on follicular maturation and the resultant corpus luteum. The lack of disturbance of routine activity makes such sampling regimens acceptable to both patients and volunteers. In addition, these investigations may provide evidence on any link between infertility and an increased risk of breast cancer. Assays for synthetic steroids in saliva may also play a role in the design of new contraceptive formulations. The development of automated assay systems and ascertainment of the applicability of salivia for protein hormone determinations would enhance future developments in this area. Although radioimmunoassay kits for salivary steroids are not available, workers are attempting to modify existing kits for plasma hormones and develop in-house methods.
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PMID:Assessment of endocrine function by salivary steroids. 1226 55

Sex education in the schools and access to a range of acceptable contraceptive methods appear to be necessary steps to halt the high incidence of unwanted pregnancy, and thus abortion, in the USSR. At present, only 17% of sexually active women in the USSR are using any form of contraception. Although the majority of Soviet youth are sexually active by the age of 15-16 years., the schools provide no information on contraception or sexually transmitted diseases. The oral contraceptives available in the USSR are high dose pills imported from Poland and Hungary, and are rejected by most Soviets because of a suspected link to breast cancer and high blood pressure. A small number of IUDs are available, but they are plastic models prone to cause infection. Condoms, too, are in short supply and are unpopular because of their thickness and poor quality. To increase the supply of high-quality condoms, organizations such as the World Health Organization, International Planned Parenthood Federation, and the United Nation Fund for Population Activities are working to import condoms from Asia. Abortion, with its possible complications of infection and infertility, remains the most widely used method of fertility control.
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PMID:Larissa's pregnant again. 1228 82

The members of the International Planned Parenthood Federation's recently formed Medical Advisory Panel met in London in October 1980 and discussed recent findings relevant to the controversial injectable contraceptive, Depo-Provera. After reviewing the evidence the panel endorsed the continued use of Depo-Provera but recognized that careful long term investigation of all types of contraceptive methods were needed. The specific conclusions reached by the members were 1) the high rate of death associated with pregnancy and illegal abortion in many developing countries, justifies the continued use of Depo-Provera; 2) monkey studies in which 2 out of 16 monkeys treated with Depo-Provera developed endometrial cancer were considered to be statistically insignifant findings; 3) there was no evidence linking the contraceptive with cervical cancer; 4) human studies show no evidence of a relationship between breast cancer and the use of Depo-Provera; 5) the results of beagle studies in which a relationship between Depo-Provera and breast cancer was observed are not applicable to humans since dogs and humans metabolize progestational steroids differently; 6) Depo-Provera may increase the amount and duration of lactation; 7) only a small fraction of the contraceptive is absorbed into the system of infants breast-fed by mothers who take Depo-Provera and follow-up studies in Chile and Mexico failed to detect any adverse effect of Depo-Provera on the infants; 8) the effects on the fetuses of women who received the injection while pregnant is unknown; 9) weight gain is the only known metabolic effect associated with the injection; 10) serious menstrual disorders among Depo-Provera users are rare; 12) the contraceptive does not appear to cause subsequent infertility.
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PMID:Injectable contraception. 1231 87

Over 60 million women use highly efficient and safe modern combined oral contraceptives (OCs) every day. A women who takes the oral contraceptive for 5 years before the age of 30 will actually live 12 days longer, although a woman taking the pill for the 1st time for 5 years after the age of 30 will have her life span reduced on the average by 80 days. OC related morbidity and mortality mostly occur in women over 35 who smoke. Combined low dose OCs are safe for women who do not smoke, at least to 45 years of age and probably to the menopause. The prescription of OCs is also safe to the young adolescent. The pill does not interfere with maturation of the hypothalamic-pituitary ovarian axis and does not increase the incidence of amenorrhoea, oligomenorrhoea or infertility in later life. Patients with contraindications to estrogen therapy are excluded from OC use (history of thromboembolism, major heart disease, liver disease, breast cancer). Low-dose (30-35 mcg estrogen-containing monophasic or triphasic) pills are recommended. Combined oral contraceptives contain either ethinyl estradiol (1.7 to 2 times more potent) or mestranol. After absorption the progestagens, norethisterone acetate, ethynodiol diacetate and lynoestrenol are all metabolized to norethisterone. The progestagen-only pill has about a 2% failure rate and poorer cycle control than the combined pill, but it lacks estrogenic, progestagenic and androgenic side effects. This pill is suitable for the lactating mother, for smokers over 35, for hypertensive patients, and for those with a history of thrombosis. The efficacy of the progestagen-only pill is restored in 3 days of pill taking. Postcoital contraception is an alternative: treatment can be given for at least 72 hours after intercourse. The Yuzpe method calls for the patient to take 2 combined oral contraceptive tablets containing levonorgestrel and ethinyl estradiol (Eugynon or Ovral) followed by a further 2 tablets 12 hours later. This regimen probably reduces the risk of pregnancy about tenfold and it is generally well tolerated.
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PMID:Oral contraceptives. 1231 13

The major trend in oral contraceptive (OC) development over the past 35 years has been a reduction in the dose of both estrogen and progestin. This fact sheet for potential OC acceptors outlines available knowledge about the effects of low-dose OC use on breast cancer, heart attack, stroke, blood clots, weight gain, nausea, and infertility. Women considering use of these formulations are urged to ensure their blood pressure is within normal limits, given the association between high blood pressure and heart disease and stroke.
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PMID:Facts about today's low-dose oral contraceptives. Patient update. 1232 Jun 51

This paper discusses the rise and use of a "woman-centred" anti-choice strategy to oppose abortion in Australia and the USA. It argues that this strategy seeks to imitate and exploit aspects of the pro-choice, women-centred position on abortion. The strategy contends that women do not really choose abortion but are pressured into it by others and then experience a range of negative effects afterwards, including an increased risk of breast cancer, infertility and post-abortion grief. Rather than evaluate the truth of such claims, this paper seeks to explicate from a feminist perspective the design, intent and implications of this strategy and how it is being used in legislative tactics, counselling, law suits and anti-choice activism. Such an analysis is necessary for pro-choice efforts to respond effectively to this new strategy, not only through literal rebuttals based on evidence, but also through responses that counter its ideological power.
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PMID:Understanding and responding to anti-choice women-centred strategies. 1236 22


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