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

Ductal carcinoma in situ (DCIS) is increasing in frequency, primarily because of the increasing use of routine screening mammography. The management of DCIS has become one of the more controversial aspects in the treatment of breast cancer. Although total mastectomy provides local control and long-term survival approaching 100%, the move to breast conservation with early invasive breast cancer has forced a re-evaluation of the treatment of in situ breast cancer. Recent advances in the evaluation and subclassification of DCIS according to histologic subgroupings and sizings have provided valuable insight into the biology of the disease. These biologic parameters may help to identify those lesions amenable to breast conservation. In properly selected patients, breast conservation affords a 1%/year local failure rate, with approximately one-half of the recurrences being invasive.
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PMID:Treatment of ductal carcinoma in situ of the breast. 166 49

The recent increase in incidence in situ breast cancer has been marked by a higher detection rate among white women. Although the increase in incidence may reflect the concomitant uptrend in mammographic screening, the lower proportion of cases among black women is of major public health concern. Time trends in the diagnosis of in situ breast cancer were evaluated in a population-based analysis of data accrued from the Metropolitan Detroit Cancer Surveillance System. The proportions of in situ cases detected among all women with breast cancer were measured annually between 1973 and 1987, and the average interval percentage changes were calculated for eight subgroups of women stratified by race and age at diagnosis. Although the proportions of in situ cancers were generally higher among white than black women, the greatest increase in average interval percentage change was observed in the oldest age category of black women. The disparity seen in younger black and white women suggests possible implications for breast cancer screening. From 1973 through 1987, the largest increase in diagnosis of in situ breast cancer occurred in black women older than 70.
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PMID:Trends in the diagnosis of in situ breast cancer in the Detroit metropolitan area, 1973 to 1987. 172 75

In situ cancer of the breast is being diagnosed with increasing frequency due to the widespread use of mammography and heightened awareness of these lesions among pathologists. Treatment of these preinvasive cancers is controversial in light of recent data supporting breast-conserving therapy for small invasive cancers. Therapy for in situ breast cancer is discussed with attention to known risk factors for recurrence and breast cancer-related mortality. The controversies surrounding treatment of ductal and lobular carcinoma in situ compel the conscientious oncologist to seek fully informed consent and to respect the individual patient's feelings about cosmesis and breast cancer risk. Hopefully, prospective randomized studies such as the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-17 trial will relieve the oncology community of much of its confusion about the natural history and optimal therapy for these diseases.
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PMID:Vexed surgeons, perplexed patients, and breast cancers which may not be cancer. 240 54

The main purpose of the present thesis has been to estimate the frequency of malignant, premalignant and benign morphological changes in the female breast and evaluate their possible interrelationship. The method used was a conventional but detailed and systematic examination, both macroscopically and histologically of all available breast tissue. Consequently autopsi material has been the natural basis of the studies. Three groups of women have been examined: 1. A consecutive series of 110 younger women, mean age 39 years, undergoing medicolegal autopsy at the Institute of Forensic Medicine in Copenhagen, Denmark, from October 1983 to July 1984. 2. A consecutive series of 83 unselected, elderly women, mean age 67 years, undergoing autopsy at a large community hospital in Esbjerg, Jutland, Denmark, from November 1976 to May 1977. 3. A consecutive series of 84 women, mean age 74 years, dying with a known diagnosis of breast cancer and undergoing autopsy at two community hospitals in the Copenhagen area, (Glostrup and Frederiksberg), Denmark, from November 1982 to December 1984. The main results were: 1. In younger women clinically occult in situ breast cancer lesions occurred with surprisingly high frequency, 18%, a result which may influence the planning of future screening programs. 2. In elderly women, dying from a number of various reasons, invasive breast carcinomas were found with a frequency corresponding to the life-long risk of Danish women having this disease diagnosed clinically, 8%. Occult in situ carcinomas were found in 18%. 3. In women dying with a clinical diagnosis of breast cancer, the frequency of malignant histological changes in the opposite breast (metastases, invasive and in situ breast carcinomas) was unexpectedly high, 80%, a result which should be taken into consideration during clinical follow-up after treatment for breast cancer.
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PMID:Autopsy studies of the occurrence of cancerous, atypical and benign epithelial lesions in the female breast. 269 56

In 84 consecutive autopsies of women with a clinical diagnosis of invasive breast cancer, radial scars were found in the contralateral breast in 35 cases (42%) by an extensive histopathologic method. Four women had radial scars on the ipsilateral side in the breast tissue available from the primary surgical procedure or at autopsy. One woman had an invasive breast cancer with morphologic features compatible with but not diagnostic of transition from a radial scar. Of the six radial scars with carcinoma in situ occurring in three women, three were of ductal and three of lobular type. In the remaining cases only radial scars with a benign appearance were found except for two with atypical hyperplasia. The frequency of radial scars was significantly higher in women with fibrocystic disease (55%) compared to women without (24%). Contralateral primary invasive and in situ breast cancer occurred in 68%. No difference in the frequency of radial scars in women with and without breast cancer was found and radial scars were not associated with any specific type of breast cancer. Our findings do not indicate a higher malignant potential of radial scars than of fibrocystic disease. It is suggested that only radial scars containing high-risk epithelial changes such as atypical hyperplasia and carcinoma in situ are associated with an increased risk of subsequent breast cancer development.
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PMID:Radial scars in women with breast cancer. 381 61

Concepts regarding cell-mediated immunity and breast cancer are reviewed. Patients having in situ breast cancers have been found by in vivo and in vitro measurements to have cell-mediated immunity to autologous and homologous in situ breast cancer tissue which may last for some time after diagnosis. These observations suggest that antigenically similar cancers arising subsequently in the contralateral breast should be less likely to progress beyond the in situ stage and, if they do become invasive, should exhibit prognostically favorable signs of cell-mediated immunity, e.g. sinus histiocytosis in the lymph nodes and/or lymphoid infiltrate and perivenous lymphoid infiltrate associated with the primary tumor. Cell-mediated immunity has also been shown to be negatively associated with the stage of disease at diagnosis for invasive cancers, i.e. the proportion of patients exhibiting cell-mediated immunity decreases as the stage at diagnosis increases. These observations suggest that the stages of independent breast cancers occurring in the same woman should be positively correlated. Data from the SEER Program of the National Cancer Institute were examined in this regard and a strong positive association between the stage of first and second independent primary breast cancers was found with the effect on the stage of a second breast cancer following a the first invasive breast cancer appearing to decrease with time subsequent to diagnosis. These observations are consistent with the immunogenicity of breast cancer.
Breast Cancer Res Treat 1984
PMID:Possible immunological implications of an association between the stages of first and second independent breast cancers. 674 42

We have analysed the age- and stage-specific breast-cancer incidence rates of Japanese and Caucasian women in Hawaii for a 20-year period. A comparison of the 1192 Japanese and 1531 Caucasian patients by stage at diagnosis showed that Japanese women were likely to have breast cancer diagnosed at an earlier stage than Caucasian women, but this difference was statistically significant only after the menopause (ages 55+). We further found that for age 50-74, the age-specific ratios of Caucasian to Japanese incidence rates were least for in situ breast cancer, and successively greater for localized, regional and distant breast cancer. We interpreted this latter finding to be an indication that postmenopausal breast cancers in Japanese women have slower average growth rates than in Caucasian women. Such slower growth rates may explain the better breast-cancer survival among Japanese women after allowing for differences in stage, tumour size, histology, or treatment.
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PMID:Stage-specific breast-cancer incidence rates by age among Japanese and Caucasian women in Hawaii, 1960-1979. 705 54

102 patients with sub-clinical intra ductal non invasive breast cancer (T0N0) treated by limited surgery and curative radiation therapy. Follow-up ranged from 2 to 10 years with a median follow-up of 59 months. The long term survival rate of this therapeutic approach, consisting of simple excision without any adjuvant treatment and radical mastectomy was close to 100%. The actuarial local recurrence rate was only 8.6% at 10 years (confidence interval: 4.6 to 12.6%), which strongly suggests that radiation therapy is active on multicentric foci. Salvage surgery could be performed in every case of local recurrence. The survival rate of in situ breast cancer (T0N0) treated by conservative radio-surgery is comparable to that of radical mastectomy, while cosmetic results and psychological impact appear to be better for the conservative technique (breast preservation rate = 91 to 96%).
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PMID:[Conservative treatment of sub-clinical noninfiltrating cancers of the breast (102 EOA in situ, TONO)]. 774 70

Cases of breast and cervical cancer account for almost 40 percent of all cancers diagnosed in Illinois (United States) women. Information on screening rates, however, is not collected routinely for the populations at risk. This paper reports on surveillance indicators designed to identify target populations and evaluate programs. All cases of cancers of the breast (n = 38,824, including in situ) and invasive cervix (n = 2,763) with a known stage, among women aged 40 to 74, were identified through the population-based Illinois State Cancer Registry for 1986 to 1992. The proportion of breast cancer cases with in situ disease-stage and cervical cancer cases with a late invasive stage were selected as surveillance indicators. Differences by age and race were evaluated, as were age- and race-specific trends. The data suggest that Black women, aged 40 to 74 years, and White women, aged 65 to 74 years, should be targeted for breast-cancer-screening interventions. All women, aged 40 to 74, should be targeted for enhanced cervical-cancer-screening interventions. Significant trends in in situ breast cancer diagnoses were apparent in all age-race groups, however no significant decline in invasive cervical cancer was found for any age-race group. The indicators identified the age- and race-specific disparities among potential target populations for breast and cervical cancer screening.
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PMID:Using central cancer-registry data to monitor progress in early detection of breast and cervical cancer (Illinois, United States). 774 55

In the past few years there has been an explosion in the number of patients diagnosed with hyperplastic breast disease and in situ breast cancer. Based on epidemiological data, these morphologically defined lesions may be categorized as those with little malignant potential (e.g. typical hyperplasia or proliferative disease without atypia [PDWA], those with significant malignant potential which may already be "initiated" (e.g. atypical ductal hyperplasia [ADH]), and early "transformed" lesions which are malignant but not yet invasive (e.g. ductal carcinoma in situ [DCIS]). They may represent sequential evolutionary stages in the ontogeny of invasive breast cancer, with each morphologically defined stage resulting from accumulating genetic changes culminating in a transformed clonal lineage capable of invasion and metastasis. Using loss-of-heterozygosity (LOH) analysis, we are studying the genetic changes associated with these lesions in archival tissue samples. 50% (6/12) of the proliferative lesions (PDWA and ADH) and 80% of the DCIS shared their LOH patterns with more advanced lesions from the same breast, strongly supporting a precursor/product relationship between these lesion and the cancers they accompany.
Breast Cancer Res Treat 1994
PMID:Molecular genetic studies of early breast cancer evolution. 781 86


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