Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The association between elevated prolactin levels and conventional antipsychotics is well-established. The novel antipsychotic, risperidone, has also been shown to elevate prolactin levels. Patients undergoing treatment with these medications are at high risk for developing hyperprolactinemia, which is associated with decreased bone mineral density, osteoporosis, menstrual disruptions and infertility, galactorrhea, breast cancer, cardiovascular disorders, and sexual impairment. Patients treated with conventional antipsychotics and risperidone should be routinely screened for hyperprolactinemia, and monitored for known sequelae. Optimally, patients with hyperprolactinemia secondary to antipsychotic drug treatment should be switched to a prolactin-sparing antipsychotic. This review will briefly highlight the regulation and function of prolactin secretion, discuss clinical effects of antipsychotic-induced hyperprolactinemia, and suggest a course of treatment.
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PMID:Hyperprolactinemia and schizophrenia: mechanisms and clinical aspects. 1598 53

Aromatase inhibitors (AI) block the last enzymatic step of estrogen production, the aromatization of the A-cycle of aromatizable androgens and particularly, androstenedione (delta4) and testosterone (T). Molecules designed for interfering with aromatase activity have existed for many years. Yet the activity of products of the aminogluthetimide era was unspecific and these substances carried too many side effects for being used clinically. Newer third generation AIs, however, are highly specific and essentially devoid of side effects. These molecules have recently been approved for treating breast cancer in postmenopausal women either, in advanced forms or, as part of adjuvant therapy. In women whose ovaries are active, a temporary inhibition of E2 production will raise gonadotropins and in turn, stimulate follicular growth. In cancer patients, this property precludes the use of AIs in women whose ovaries are still active, unless gonadotropins are blocked. But in infertility patients, this property of AIs has been put to play for inducing ovulation. AIs have been used both in women who do not ovulate but whose hypothalamo-pituitary-gonadal (HPG) axis is active (oligo-anovulators of PCOD type) and those who ovulate regularly but in whom multiple ovulation is sought for treating unexplained infertility or as part of IVF. Like clomiphene citrate (CC), AIs are not usable in women whose gonadotropins are suppressed, as in the case of hypothalamic amenorrhea. The sum of data available on the use of AI for inducing ovulation remains however meager to this date and is mainly constituted of pilot and non-randomized trials. Yet mounting evidence tends to support AIs' advantages over CC for induction of ovulation. Hence, we think that the likelihood that these drugs will play a key role in induction of ovulation in the future is high. AIs appear particularly interesting for treating unexplained infertility because AI-FSH/hMG regimens are lighter than FSH-only regimens while retaining the high pregnancy rates of these latter treatments.
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PMID:Clinical use of aromatase inhibitors (AI) in premenopausal women. 1868 52

Estrogens, acting through its two receptors, ESR1 (hereafter designated ER alpha) and ESR2 (hereafter designated ER beta), have diverse physiological effects in the reproductive system, bone, cardiovascular system, hematopoiesis, and central and peripheral nervous systems. Mice with inactivated ER alpha, ER beta, or both show a number of interesting phenotypes, including incompletely differentiated epithelium in tissues under steroidal control (prostate, ovary, mammary, and salivary glands) and defective ovulation reminiscent of polycystic ovarian syndrome in humans (in ER beta-/- mice), and obesity, insulin resistance, and complete infertility (both in male and female ER alpha-/- mice). Estrogen agonists and antagonists are frequently prescribed drugs with indications that include postmenopausal syndrome (agonists) and breast cancer (antagonists). Because the two estrogen receptors (ERs) have different physiological functions and have ligand binding pockets that differ enough to be selective in their ligand binding, opportunities now exist for development of novel ER subtype-specific selective-ER modulators.
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PMID:Estrogen receptor beta in health and disease. 1603 96

The young specialty of reproductive medicine has developed tremendously in barely 30 years and has taken a prominent place in the field of obstetrics and gynaecology. In addition to the diagnosis and treatment of infertility, reproductive medicine comprises a large number of medical activities, most of which affect women in almost all phases of life, from shortly after puberty to old age. A key role is played by the pathophysiology of ovarian function and ovarian hormones. Requests for medical assistance concern: disorders of sexual development, the consequences for health in the short- and long-term of overweight and anovulation early in life, premature menopause and the need for hormone replacement, damage to the ovaries as a result of radio- or chemotherapy for cancer, the hormonal aspects of breast cancer, the hormonal aspects of sexuality and well-being, and counselling regarding contraception or menopausal symptoms and hormone replacement.
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PMID:[Reproductive medicine: more than the diagnosis and treatment of infertility]. 1632 Jun 75

Although after the discovery of GnRH, research was initially directed towards the treatment of infertility, the development during the last twenty-five years of synthetic GnRH analogs has led to major advances in the diagnosis and treatment of endocrine disorders and cancer. Agonists are 50-100 times more potent than the natural neuropeptide and induce an intense and constant secretion of gonadotrophins, while their continuous administration induces hypophyseal desensitization with a fall in FSH and LH production leading to a reduction in sex hormones production and therefore chemical castration. This has been used for the treatment of precocious puberty, in vitro fertilization protocols and management of various hormone-dependent cancers such as prostate and breast cancer, a field where these indications are being continually extended. LHRH antagonists, used at doses higher than those of agonists, induce an immediate inhibition of gonadotrophin secretion and rapidly reduce sex steroid levels. Their development is more recent, and they have begun to find a role in prostatic diseases, cancer and benign prostatic hypertrophy. The discovery of GnRH receptors in various types of cancer has suggested a direct cytotoxic effect on cancer cells as well as the indirect hormonal effect. Research currently in the preclinical stage involves the use of combinations of ligand analogs and cytotoxic agents to increase the anti-tumoral specificity of chemotherapy and provide greater efficacy and reduced collateral toxicity. The management strategy of prostate, breast and ovarian cancers may therefore be considerably modified. Likewise, this concept of targeted chemotherapy using analogs acting as cytotoxic agent carriers up to the tumor site is the aim of research to evaluate somatostatin and bombesin.
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PMID:[The discovery of hypothalamic hormones and the development of antitumor analogs]. 1630 10

Available literature concentrates on infertility concerns of young women with breast cancer, while attention to psychosocial issues related to maintained or regained fertility is scarce. As part of a longitudinal, qualitative study of experiences of young women with breast cancer (diagnosed at 40 years or younger); (n = 13), concerns about fertility, contraception, pregnancy, and breastfeeding after breast cancer were expressed. Using semistructured, one-to-one interviews over three time phases, we explored these women's experiences. Perceptions of fertility changed over time. Contraception issues were raised together with recurrence fears related to pregnancy and breastfeeding after breast cancer. Decisions related to unplanned pregnancies and breastfeeding were described as particularly onerous.
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PMID:A qualitative analysis of reproductive issues raised by young Australian women with breast cancer. 1633 42

Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women on reproductive age. PCOS is characterized by the presence of anovulation, infertility and hyperandrogenism and is associated with obesity and insulin resistance. A major risk for neoplasms of the reproductive tract, like endometrial, breast and ovary cancer seems to be related to PCOS. While several studies have shown an increased risk for endometrial hyperplasia and cancer in PCOS patients, the variability of the selection criteria for PCOS has been recognized as a potential bias for these data. PCOS women also present clinical characteristics that are related to risk factors for breast cancer and some epidemiological evidences have been described on this issue. However, until now, a clear association between the presence of PCOS and breast carcinoma has yet not been found. Finally, high local steroid and growth factor concentrations are considered risk factors for ovary carcinoma, and are frequently observed in PCOS women. In turn, few studies have addressed the possibility of a link between PCOS and ovarian cancer and the results are conflicting but suggest that this association is unlikely.
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PMID:[Polycystic ovary syndrome associated neoplasms]. 1644 64

Klinefelter syndrome is a well documented abnormality of sex differentiation, with an incidence of 1 in 600 newborn males. It is characterized by a 47,XXY or a mosaic karyotype and clinical findings of hypergonadotrophic hypogonadism, small testes, infertility, reduced body hair, gynecomastia, and tall stature. Other conditions like venous disease, autoimmune disorders, mild neurobehavioral deficit, diabetes mellitus, sexual precocity, and osteoporosis may also affect these patients. Different malignancies such as breast cancer, testicular tumors, leukemia, and lymphomas occur in 1%-2% of the cases. Klinefelter syndrome has been associated with other malignancies such as extragonadal germ cell tumors; however, some authors consider this association an unusual finding. We report the molecular cytogenetic studies performed in 4 young males with mediastinal germ cell tumors. In 2 cases, a 47,XXY karyotype was recognized in different tissues by fluorescent in situ hybridization, whereas the other 2 had a normal XY karyotype. We propose that in young patients with mediastinal teratoma, a cytogenetic analysis must always be performed.
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PMID:Extragonadal germ cell tumors are often associated with Klinefelter syndrome. 1656 24

Lesions of the male breast are rather rare. The most frequent lesion is gynecomastia followed by breast cancer. Gynecomastia is well known but male breast cancer is a rather rare tumor. It occurs in less than 1% of all cancers in men and of breast cancers. The mean age is high with a median of 68 years. Predisposing factors appear to be associated with hyperestrogenism such as testicular factors including maldescensus, orchitis and infertility. Other factors are Klinefelter, adipositas, diabetes mellitus and liver disease. In recent years an increased risk of male breast cancer has been reported in families with positive family history and in which BRCA2 mutations have been identified. Diagnostic procedures for male breast lesions should be the same as for the female breast. Underdiagnosis of male breast lesions is a frequently reported problem. Histology of male breast cancer differs in some aspects from female breast cancer. Male breast cancers are more frequently invasive ductal, G3 and steroid hormone receptor positive. In case of intraductal cancer male lesions are more frequently papillary. Lobular carcinomas almost never occur. Prognostic factors for male breast cancer are similar to female breast cancer. For male breast cancer no randomised therapy studies are described. Therefore all therapy strategies are extrapolated from female breast cancer. The existing main therapeutic problem is undertreatment.
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PMID:[Lesions of the male breast]. 1689 48

The occurrence of early-stage breast cancer in premenopausal women who desire children is a considerable clinical challenge. The frequent use of adjuvant cytotoxic chemotherapy can induce ovarian failure and infertility, while the frequent use of adjuvant hormonal therapy is a contraindication to conception. A variety of techniques to preserve fertility in spite of adjuvant chemotherapy are under investigation, with promising early results. Ovarian stimulation with retrieval of eggs for in vitro fertilization and cryopreservation prior to the commencement of chemotherapy seems to hold the greatest promise for patients. There is no evidence that patients treated with curative intent for early-stage breast cancer who subsequently become pregnant have a compromised survival, but patients should be counseled regarding their risk of recurrence in general and whether a high recurrence risk might make subsequent pregnancy and motherhood an unwise choice. The offspring of breast cancer survivors do not appear to suffer deleterious consequences as a result of the diagnosis or treatment of the mother.
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PMID:Preservation of fertility and the impact of subsequent pregnancy in patients with premenopausal breast cancer. 1714 46


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