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

Cystosarcoma phylloides is a breast neoplasm that has a frequently unpredictable clinical course. We made a retrospective study of 25 patients with this disease in an attempt to evaluate the indicators of aggressive behavior. In our series, older patient age, nulliparity, rapid tumor growth, pain, and large size of tumors increased the suspicion of malignancy but were not always reliable indicators of malignancy. Skin ulceration, tumor necrosis, and infiltrating tumor margins were the most ominous characteristics. High-grade tumors, that is, those with increased cellularity, vascularity, mitotic figure, and pleomorphism, often indicated aggressive behavior. Mixed mesenchymal components were sometimes related to a malignant course. We found a 24 percent incidence of associated breast cancer. Carcinoma of the ipsilateral breast was found in four patients and later in the contralateral breast in two patients. Of our 25 patients, 10 (40 percent) had recurrence and 4 (16 percent) died from disease. Recurrences after treatment usually occurred within 3 years. Patients must be followed carefully for local recurrence or metastases, since the clinical course is not predictable. Forty percent of the lesions were diagnosed as being malignant. Local excision was associated with recurrence in six of eight patients and was clearly inadequate treatment. Quadrantectomy was effective for benign peripheral lesions when a generous margin could be obtained. From these data, we believe that mastectomy is indicated in all patients with malignant lesions and in those with large benign lesions.
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PMID:Prognostic indicators in cystosarcoma phylloides. 303 Jan 51

For the purpose of local therapy for advanced and recurrent breast cancer, we have applied a new Adriamycin (ADR) ointment. This new ADR ointment has been prepared by the technique of a two-factor composite experimental design and includes PEG: 25%, CVP: 0.65%, HPC: 1.35% and ADR: 0.04%. We have applied it to three patients with advanced breast cancer and six patients with locally recurrent breast cancer. By using this ointment, the skin ulcers have become dry, bleeding has stopped and the sense of heat has been lost. In some cases, the neoplastic ulcers have diminished in size. Some problems with this ointment are easy bleeding at the time of removing the gauze and an unstable effect in diminishing the size of the neoplasm. We therefore think that the use of this ointment alone is very effective for controlling the symptoms of the local lesion, but not so effective for diminishing the size of the neoplasm.
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PMID:[Clinical evaluation of adriamycin ointment in advanced or local recurrent breast cancer]. 395 81

Radiotherapy can be followed by recalcitrant skin ulcers. As low intensity laser irradiation has been demonstrated to have a beneficial effect on impaired wound healing, we investigated its efficacy and safety in three patients with chronic radiation ulcers. The three patients, previously mastectomized due to breast cancer, with recalcitrant radiation ulcers of the skin were treated with a 30 mW helium-neon laser (wavelength: 632.8 nm, intensity: 3 mW/cm2, dose: 30 J/ cm2) three times weekly. In all patients, complete wound closure was achieved within a period of 7, 5, and 8 weeks. One patient died 6 weeks after laser treatment due to tumor cachexia. Neither of the other patients showed recurrence of radiation ulcers or neoplasm during a follow-up of 36 months. Low intensity helium-neon laser irradiation has been shown to be effective in the induction of wound healing in radiotherapy-induced ulcers in three patients with breast cancer.
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PMID:Low intensity laser irradiation in the treatment of recalcitrant radiation ulcers in patients with breast cancer--long-term results of 3 cases. 1072 63

We analyzed response, side effects, and local control rates of a multimodal treatment consisting of intraarterial infusion chemotherapy (IAIC) and radiotherapy with or without surgery for patients with locally advanced or recurred breast cancer. Thirty-three patients, clinically diagnosed as stage IIB in 1, IIIA in 2, IIIB in 12, IV in 18, were treated from 1991 to 1998. Twenty-five were primary and eight were recurrent cases after surgery. IAIC started as initial treatment up to three times maximum. In most cases, doxorubicin 50 mg, cisplatin 50 mg, and mitomycin 10 mg were infused in the subclavian and/or internal mammary artery. After IAIC, patients in primary cases underwent radical mastectomy or breast conservation surgery, after radiotherapy at a total dose of 50 Gy/25 fractions/5 weeks with a boost of 10 Gy. In recurrent cases, a full dose of radiotherapy was delivered. Clinical objective and complete response rates were 78% and 9% after IAIC. Despite a high rate of residual positive margin (67%) or clinically residual carcinoma, local recurrence developed only in 2 patients (6%) and local control rates at 5 years were calculated as 89%. Bone marrow suppression was frequent, and skin vesiculation (15%) and ulceration (9%) were experienced after IAIC. Skin ulcer (6%), brachial plexus neuropathy (3%), and radiation pneumonitis (3%) occurred as late toxicity. IAIC was effective as an induction treatment and radiotherapy played a role of local control for patients with locally advanced or recurrent breast cancer.
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PMID:Intraarterial infusion chemotherapy and radiotherapy with or without surgery for patients with locally advanced or recurrent breast cancer. 1131 96

Skin ulceration is an uncommon, but serious manifestation of locally advanced breast cancer. When the ulcerations present with bleeding, they can be particularly difficult to treat. Cautery often fails because the electrode adheres to the skin and rebleeding begins when the instrument is pulled away. We present a case in which argon beam coagulation was used to achieve hemostasis in a bleeding breast ulceration.
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PMID:The Use of Argon Beam Coagulation in the Management of Bleeding from an Ulcerated Breast Lesion. 1134

We present a 38-year-old premenopausal Japanese woman with invasive micropapillary carcinoma (IMC) of the left breast with minimal lymph node metastasis despite a huge size. The patient noticed a left breast mass and a bloody nipple discharge 2 years before admission. On admission, physical examination revealed a huge, elastic hard mass with skin ulcer 12x12 cm in diameter occupying the entire left breast. The patient underwent modified radical mastectomy with level III lymph node dissection, and the defect was reconstructed with a vertical rectus abdominis myocutaneous flap. Histopathologically, IMC comprised about 60% of the tumor, admixed with papillotubular and mucinous carcinoma. Only one of twenty-five lymph nodes had tumor metastasis. The patient remains well 8 months postoperatively without any signs of recurrence.
Breast Cancer 2003
PMID:Invasive micropapillary carcinoma of the breast with minimal regional lymph node metastasis regardless of the huge size: report of a case. 1463 15

We reported a successful operative case of solitary metastasis in the sternum 15 years after radical operation for a breast cancer and a primary lung cancer. The patient was a 59-year-old woman who was admitted for skin ulcer and tumor of the anterior chest wall. Histological diagnosis by skin biopsy was metastasis of breast cancer. Concurrently, chest computed tomography (CT) revealed a coin lesion with slight spiculation at the right lower lobe. Because histological diagnosis by the partial resection of the right lower lobe was primary lung cancer, we performed right lower lobectomy. Twenty-four days after the operation, subtotal sternal resection was carried out. She is alive and well without any complaints.
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PMID:[Recurrent breast cancer to the sternum 15 years after radical mastectomy and primary lung cancer; report of a case]. 1555 40

We report a case of breast cancer with spinal and vertebral lesions. A 49-year-old premenopausal woman with a left breast tumor was admitted to our hospital for acute weakness of the lower limbs and dysuria. She could neither stand nor walk. The tumor in the left breast was 5.0 cm in diameter with skin ulcer, and it was diagnosed as breast cancer. Magnetic resonance (MR) image showed multiple vertebral and spinal metastases from breast cancer. Chemotherapy, consisting of cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) was initiated. Her symptoms dramatically changed for the better. She became able to walk and urinate. We performed palliative mastectomy after 3 cycles of CAF therapy. Histopathological findings of breast tumor showed scirrhous carcinoma. Although the estrogen and progesterone receptor status of primary tumor was negative, chemo-endocrine therapy, consisting of medroxyprogesterone acetate (MPA) and doxifluridine (5'-DFUR) was given as daily therapy, and vertebral and spinal lesions were reduced. Her condition has remained stable for 4 years. For patients with metastatic breast cancer, complete remission is uncommon, and disease stabilization is a reasonable goal of successful therapy. In this respect, therapy with CAF, followed by MPA and 5'-DFUR, was successful in the patient.
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PMID:[Successful combination therapy with 5'-DFUR and MPA for breast cancer with spinal and vertebral metastases]. 1562 61

We report three cases with advanced breast cancer were treated with a weekly dose of paclitaxel (TXL). Case 1: A 52-year-old female, diagnosed as having bilateral breast cancer with metastatis to right lung (S9) and sternum. A TXL weekly regimen was started (80 mg/m2 with the administration of the drug for three weeks followed by one week rest as one course). After twelve courses of treatment, bilateral breast masses significantly regressed with the disappearance of bilateral axillary and parasternal lymph node metastasis. The tumor marker was normalized, too. After two years and four months, the patient is still alive and continuing the weekly TXL regimen. Case 2: A 51-year-old female with right breast cancer and skin ulcer formation. After completing two courses of weekly TXL regimen, her mass was markedly reduced in size, which made it possible for her to undergo a modified mastectomy. Case 3: A 52-year-old female with breast cancer which invaded the skin. As a result of two courses of weekly TXL therapy, the tumor responded significantly and a modified mastectomy was conducted. The TXL weekly regimen seems to be very effective in regressing breast tumors and can be given safely in the outpatient setting with an extremely high utility profile as neoadjuvant chemotherapy as well.
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PMID:[Three cases of advanced breast cancer successfully treated with a weekly dose of paclitaxel]. 1585 23

Pseudallescheria boydii is a ubiquitous filamentous fungus. We report a case of cutaneous P. boydii infection of the left knee in a 79-year-old Japanese man who was receiving oral predonisolone (25 mg/day) for radiation pneumonitis after radiation therapy on left breast cancer. He presented with a 2-week-history of a lesion on the left knee. A biopsy specimen from the skin lesion revealed granulomatous inflammation with hyphae. Culture of the pus from the skin specimen confirmed the diagnosis of cutaneous P. boydii infection. rDNA ITS sequence was analyzed to confirm the mycological diagnosis. The patient was treated orally with 200 mg/day of itraconazole. The lesion was gradually cured and left a hypertrophic scar. Cutaneous injury may be responsible for an incidence of localized infection. Such rare fungus infection in immunocompromised patients who have a persistent traumatic skin ulcer needs to be ruled out. An opportunistic infection in immunocompromised patients can be life-threatening and prompt treatment based on accurate diagnosis is important.
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PMID:[Case of cutaneous Pseudallescheria boydii infection caused by trauma]. 1845 93


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